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. 2012 Oct;1(4):180-187.
doi: 10.1016/j.msard.2012.06.002.

Treatment of Neuromyelitis Optica: Review and Recommendations

Dorlan J Kimbrough  1 , Kazuo Fujihara  2 , Anu Jacob  3 , Marco A Lana-Peixoto  4 , Maria Isabel Leite  5 , Michael Levy  1 , Romain Marignier  6 , Ichiro Nakashima  2 , Jacqueline Palace  5 , Jérôme de Seze  7 , Olaf Stuve  8 , Silvia N Tenembaum  9 , Anthony Traboulsee  10 , Emmanuelle Waubant  11 , Brian G Weinshenker  12 , Dean M Wingerchuk  13 ; GJCF-CC&BR
Affiliations

Treatment of Neuromyelitis Optica: Review and Recommendations

Dorlan J Kimbrough et al. Mult Scler Relat Disord. 2012 Oct.

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 mitoxantrone. This review provides a comprehensive analysis of each of these medications in NMO and concludes with a set of recommended consensus practices.

Keywords: Neuromyelitis optica; aquaporin 4; drug therapy; immunosuppression.

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