モノクローナル抗体製剤により変わる視神経脊髄炎の治療戦略

抄録

Traditional relapse–preventative therapy for neuromyelitis optica spectrum disorders (NMOSD) with immunosuppressive treatment has been mainly based on retrospective case series and consensus reports. However, the accumulating knowledge of underlying disease mechanisms has allowed the development of new drugs. The results of recent randomized clinical trials of three different monoclonal antibodies targeting different molecules provided Class I evidence for their use in patients with anti–aquaporin–4 antibody–positive NMOSD. The first approved agent in Japan is eculizumab, a humanized monoclonal antibody against complement protein C5. The second agent is satralizumab, a humanized monoclonal antibody against IL6 receptor with a longer half–life. A recently approved agent is inebilizumab, a humanized, affinity optimized, monoclonal antibody against B–cell surface antigen CD19. In this symposium, I review the available clinical data on three monoclonal antibodies and discuss the potential future treatment approaches in NMOSD.