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ECTRIMS 2023 | Evolution of understanding and treatment in NMOSD

Brian Weinshenker, MD, Mayo Clinic, Rochester, MN, delves into the history and progression of understanding in neuromyelitis optica spectrum disorder (NMOSD), which, two decades ago, was considered a severe variant of multiple sclerosis (MS). The pivotal moment came in 2004 when an antibody specific to NMOSD was identified, further pinpointed in 2005 as reacting with the aquaporin-4 protein on astrocytes. This distinction clarified that treatments effective for MS might not benefit NMOSD patients. The N-MOmentum study (NCT02200770) focused on inebilizumab, a B-cell depleting drug targeting CD19, which demonstrated a significant reduction in NMOSD attacks over six months. Although multiple effective treatments for NMOSD now exist, the challenge remains in identifying the best agent for individual patients. This interview took place at the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) Congress 2023 in Milan, Italy.

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BG Weinshenker received payments for serving as chair of attack adjudication committees for clinical trials in NMOSD for Alexion, MedImmune, UCB Biosciences, and Horizon Therapeutics; has consulted with Chugai, Genentech, Horizon Therapeutics, Mitsubishi Tanabe Pharma, Roche Pharmaceuticals and CANbridge; and has a patent for NMO-IgG for diagnosis of neuromyelitis optica, with royalties paid by Hospices Civils de Lyon, MVZ Labor PD Dr. Volkmann und Kollegen GbR, University of Oxford, and RSR.