Jodie M. Burton, MD, MSc, FRCPC, University of Calgary, Alberta, Canada, discusses the progress made in the treatment of neuromyelitis optica spectrum disorder (NMOSD), particularly following the advent of targeted therapies. Historically, patients diagnosed with NMOSD had a poor prognosis, with blindness and paralysis commonly occurring not long after diagnosis and life expectancy being 5 years in a large proportion of cases. As the immune mechanisms underpinning the condition have been investigated and better understood, there has been an emergence of targeted therapies which allow for a precision approach to treatment and have substantially improved disease outcomes and quality of life of patients. Examples of these include complement focused agents (eculizumab, ravulizumab), IL-6 targeting agents (satralizumab) and B-cell targeting therapies (rituximab, inebilizumab). Although the treatment of the disease has been revolutionized, Dr Burton highlights that, as many of these agents are administered intravenously on a regular basis, the primary limiting factors in delivering these therapeutic options to patients are access and cost. This interview took place at the World Congress of Neurology (WCN) 2023 in Montreal, Canada.
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