When an acute NMOSD attack does not respond sufficiently to initial treatment, a structured rescue protocol is indicated. This protocol defines the apheresis-based intervention and accounts for patients with varying attack severity.
This protocol applies to acute NMOSD attacks where the initial treatment response has been insufficient and escalation to apheresis therapy is warranted. Patients with severe attacks represent a distinct consideration within the structured approach.
The protocol centres on apheresis therapy — either therapeutic plasma exchange or immunoadsorption — as the core rescue intervention. For patients with severe attacks, the structured protocol includes additional considerations for combined therapy. Complete sequencing, eligibility criteria, and full regimen details are available in the protocol.
DOI: 10.1007/s00415-024-12288-2