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ECTRIMS 2023 | Distinctive attributes and efficacy of inebilizumab in NMOSD

Brian Weinshenker, MD, Mayo Clinic, Rochester, MN, comments on the potential advantages of inebilizumab over rituximab in treating neuromyelitis optica spectrum disorder (NMOSD). Historically, NMOSD was often misclassified as a severe form of multiple sclerosis. However, the discovery of an antibody specific to aquaporin-4, a protein found on astrocytes, distinguished NMOSD. Inebilizumab’s uniqueness lies in its glycoengineering and afucosylation, enhancing its affinity for the FC receptor, thereby facilitating antibody-dependent cellular cytotoxicity. An important observation was the potential effect of a polymorphism in the CD16 protein, which, when considering rituximab, had implications on drug efficacy. However, with inebilizumab, this polymorphism did not significantly affect the therapeutic outcomes. Prof. Weinshenker suggests that these distinctions may provide reasons why inebilizumab might offer superior outcomes compared to rituximab in NMOSD treatment. 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.