Real World Effectiveness and Tolerability of Novel Monoclonal Antibodies and Rituximab for NMOSD
In this multicenter retrospective cohort study of 135 people with aquaporin-4 IgG+ neuromyelitis optica spectrum disorder (NMOSD), some of whom were exposed to multiple therapies, we evaluated the effectiveness and tolerability of rituximab (n = 111) and novel monoclonal antibodies (nMAbs): eculizumab (n = 9), inebilizumab (n = 23), and satralizumab (n = 14). Over a median follow-up of 3.92 years, 21/111 rituximab-treated patients relapsed. In contrast, relapse occurred in only 1/23 inebilizumab-treated patients (median follow-up 1.27 years), with no relapses observed in those receiving eculizumab or satralizumab. Twelve-month relapse-free probabilities were 92% (rituximab), 94% (inebilizumab), and 100% (eculizumab and satralizumab). Among those with available MRI data, 10/73 rituximab and 1/14 inebilizumab developed new lesions. There were no serious adverse events. These findings support nMAbs as effective and well-tolerated first-line therapies for NMOSD.
Authors
- Amy Kunchok (ORCID: https://orcid.org/0000-0002-8387-6491)
- Daniel Ontaneda (ORCID: https://orcid.org/0000-0002-2838-9148)
- Le H. Hua (ORCID: https://orcid.org/0000-0002-0535-3978)
- Justin Abbatemarco (ORCID: https://orcid.org/0000-0003-1668-4753)
- Mengke Du (ORCID: https://orcid.org/0009-0004-6283-1990)
- Mary R. Rensel (ORCID: https://orcid.org/0000-0001-9613-8394)
- Carrie M. Hersh (ORCID: https://orcid.org/0000-0002-5716-5645)
- Devon Conway (ORCID: https://orcid.org/0000-0001-5359-6686)
- Jeffrey Cohen
- Zarmina Javed
Institutions
- Cleveland Clinic (US)
- Lou Ruvo Brain Institute (US)
- Quantitative BioSciences (US)
Publication Details
- Journal
- Annals of Clinical and Translational Neurology
- Published
- 2025-08-22
- DOI
- https://doi.org/10.1002/acn3.70160
- Citations
- 2
- Primary Topic
- Systemic Sclerosis and Related Diseases
- Type
- article
- Field-Weighted Citation Impact
- 2.94
Funders
- Amgen
- Bristol-Myers Squibb
- Sanofi
- Biogen
- Patient-Centered Outcomes Research Institute
- Alexion Pharmaceuticals
- TG Therapeutics
- Race to Erase MS
- Horizon Therapeutics
- Multiple Sclerosis Society
- National Institutes of Health
- Agency for Healthcare Research and Quality
- Genentech
- EMD Serono
- National Institute of Neurological Disorders and Stroke