Treatment of Acute Attacks in Neuromyelitis Optica Spectrum Disorder
Neuromyelitis optica spectrum disorder (NMOSD) is managed through structured acute-attack protocols. This protocol covers the treatment approach for acute attacks, including patients who show insufficient response or persistent functional deficits after initial treatment.
The protocol applies to patients experiencing NMOSD attacks — including those who did not adequately respond to, or continued to exhibit functional deficits following, an earlier treatment course.
Treatment Approach
The approach involves repeated treatment courses targeting acute attacks, and may include certain experimental therapies in selected patients. The complete sequence, agent selection, and decision criteria are detailed in the full protocol.
References
- A repeated treatment course has also been shown to improve outcomes and lower the number of non-responders.
- Thus, patients may benefit from repeated therapy courses (apheresis and/or glucocorticoids) if they insufficiently responded or continued exhibiting functional deficits after the first or second treatment course for NMOSD attacks.
- Other experimental therapy approaches, such as intravenous immunoglobulins (IVIG), early anti-CD20 therapy, and early anti-complement therapy, have been reported in single case series to possibly lead to favorable outcomes in acute attacks.
DOI: 10.1007/s00415-024-12288-2
View source ↗