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ACTRIMS 2024 | An overview of the current treatment options for NMOSD from ACTRIMS 2024

Dalia Rotstein, MD, MPH, St. Michael’s Hospital and the University of Toronto, Toronto, ON, gives an overview of the current treatment options for neuromyelitis optica spectrum disorder (NMOSD). Based on positive clinical trial findings, monoclonal antibodies with three mechanisms of action are currently approved for use. These include C5 complement inhibitors (ravulizumab and eculizumab), interleukin-6 (IL-6) receptor inhibitors (satralizumab), and anti-CD19 agents (inebilizumab). Rituximab, an anti-CD20 antibody, is also used off-label, with evidence for high efficacy. In countries with issues accessing these agents, older drugs such as azathioprine and mycophenolate are commonly used, but their efficacy may be inferior to the newer antibodies. When making clinical treatment decisions, physicians should consider comorbidities and patient preferences. This interview took place during the annual ACTRIMS Forum 2024.

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