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ECTRIMS 2023 | Prospects and challenges in NMOSD treatment

Brian Weinshenker, MD, Mayo Clinic, Rochester, MN, delves into the challenges of determining the optimal treatment for neuromyelitis optica spectrum disorder (NMOSD). With the emergence of various effective drugs, discerning which medication to use first remains elusive, given the similarity in efficacy and the diverse patient demographics across clinical trials. Although the potential role of polymorphisms in predicting responses to treatments like inebilizumab was discussed, the clinical relevance in guiding therapy appears limited. Emphasizing the long-term nature of NMOSD treatment, Prof. Weinshenker suggests that the current therapies are not curative, hence the rising interest in immune tolerance strategies. These strategies aim to modify the immune system for a lasting impact, allowing potential discontinuation of prolonged treatments in the future. 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.