Treatment of neuromyelitis optica: Review and recommendations

Neuromyelitis optica (NMO) is an autoimmune demyelinating disease preferentially targeting the optic nerves and spinal cord. Once regarded as a variant of multiple sclerosis (MS), NMO is now recognized to be a different disease with unique pathology and immunopathogenesis that does not respond to tr...

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Détails bibliographiques
Auteurs principaux: Kimbrough, D, Fujihara, K, Jacob, A, Lana-Peixoto, M, Isabel Leite, M, Levy, M, Marignier, R, Nakashima, I, Palace, J, De Seze, J, Stuve, O, Tenembaum, SN, Traboulsee, A, Waubant, E, Weinshenker, BG, Wingerchuk, D, Guthy Jackson Charitable Foundation Clinical Consortium and Biorepository
Format: Journal article
Langue:English
Publié: Elsevier 2012
Description
Résumé:Neuromyelitis optica (NMO) is an autoimmune demyelinating disease preferentially targeting the optic nerves and spinal cord. Once regarded as a variant of multiple sclerosis (MS), NMO is now recognized to be a different disease with unique pathology and immunopathogenesis that does not respond to traditional MS immunomodulators such as interferons. Preventive therapy in NMO has focused on a range of immunosuppressive medications, none of which have been validated in a rigorous randomized trial. However, multiple retrospective and a few recent prospective studies have provided evidence for the use of six medications for the prevention of NMO exacerbations: azathioprine, rituximab, mycophenolate mofetil, prednisone, methotrexate and mitoxantrone. This review provides a comprehensive analysis of each of these medications in NMO and concludes with a set of recommended consensus practices. Copyright 2012 Elsevier B.V.