Managing NMOSD
  • Relapse prevention for long-term stabilisation of disease course
  • Acute relapse management and improvement of relapse-associated symptoms

Furthermore, symptomatic treatment of residual symptoms (such as gait impairment, weakness and spasticity, neuropathic pain and low vision) is often necessary to improve the patient’s quality of life.3,4

Several treatment options for NMOSD that are mentioned below are off-label but have been used historically and are included in treatment recommendations and algorithms.4,5
In current practice, the following options are considered for the management of acute relapses:
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AQP4, aquaporin-4; CNS, central nervous system; IA, immunoadsorption; IgG, immunoglobulin G; IV, intravenous; IVIg, IV immunoglobulin; NMOSD, neuromyelitis optica spectrum disorder; PE plasma exchange.
Capobianco M, et al. Characterization of disease severity and stability in NMOSD: A global clinical record review with patient interviews. Neurol Ther. 2023;12(2):635–650.  Royston M, et al. Neuromyelitis optica spectrum disorder: Clinical burden and cost of relapses and disease-related care in US clinical practice. Neurol Ther. 2021;10(2):767–783.  Trebst C, et al. Update on the diagnosis and treatment of neuromyelitis optica: Recommendations of the Neuromyelitis Optica Study Group (NEMOS). J Neurol. 2014;261(1):1–16.  Wingerchuk DM, Lucchinetti CF. Neuromyelitis optica spectrum disorder. N Engl J Med. 2022;387(7):631–639. Jarius S, et al. Neuromyelitis optica. Nat Rev Dis Primers. 2020;6(1):85.  Shi M, et al. Progress in treatment of neuromyelitis optica spectrum disorders (NMOSD): Novel insights into therapeutic possibilities in NMOSD. CNS Neurosci Ther. 2022;28(7):981–991. Kessler RA, Mealy MA, Levy M. Treatment of neuromyelitis optica spectrum disorder: Acute, preventive, and symptomatic. Curr Treat Options Neurol. 2016;18(1):2.  Chan KH, Lee CY. Treatment of neuromyelitis optica spectrum disorders. Int J Mol Sci. 2021;22(16):8638.