Treatment of neuromyelitis optica: Review and recommendations

Kimbrough, DJ
Fujihara, K
Jacob, A
Lana-Peixoto, MA
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, DM

Open link

Publication date

October 2012

DOI

10.1016/j.msard.2012.06.002

Publisher

Elsevier BV

Journal

Multiple Sclerosis and Related Disorders

Abstract

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 mitoxantr...