Transitioning immunotherapy in neuromyelitis optica spectrum disorder - when and how to switch.

Abstract

INTRODUCTION:

Newly approved immunotherapies for neuromyelitis optica spectrum disorder (NMOSD) have transformed the treatment landscape and improved disability outcomes. However, there are many remaining questions regarding transitioning immunotherapies in NMOSD that have not been addressed by randomized controlled trials.

AREAS COVERED:

This review focuses on the practical questions of managing and switching immunotherapies for NMOSD, including how to transition between immunotherapies, deciding when and if therapy should be discontinued, and transitioning during pregnancy or breastfeeding.

EXPERT OPINION:

Clinical experience and retrospective studies of real-world outcomes and complications associated with therapy, as well as therapy transitions, will help inform practice patterns moving forward. Strategies for transitioning between immunotherapies should consider the pharmacokinetics and the onset of clinical efficacy for each drug. Despite all the currently approved preventative immunotherapies, there are limited treatment options for those suffering from significant disability after their initial attack, and remyelination therapies are an important area for future research.

• Authors: Anastasia Vishnevetsky, Tamara B Kaplan, Michael Levy
• Journal: Expert opinion on biological therapy (Expert Opin Biol Ther) Vol. 22 Issue 11 Pg. 1393-1404 (11 2022) ISSN: 1744-7682 [Electronic] England
• PMID: 36369948 (Publication Type: Review, Journal Article)

Chemical References

• Immunologic Factors

Topics

• Pregnancy
• Female
• Humans
• Neuromyelitis Optica (drug therapy)
• Retrospective Studies
• Immunologic Factors (therapeutic use)
• Immunotherapy (adverse effects)
• Treatment Outcome