Updates of B cell targeted treatment and inebilizumab in NMOSD

Abstract

Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune disease caused by anti–aquaporin 4 antibody. One of the main cause of tissue injury is mediated by complement–dependent cytotoxicity against astrocytes. Now humoral immunity is the main target in NMOSD, there are 4 generally–approved antibiotics including eculizumab, satralizumab, inebilizumab, and rituximab. Anti–CD19 antibiotics, inebilizumab, is a well–tolerated treatment, which could start with two doses / months followed by injection every half a year. It is important to know the long–term safety of inebilizumab treatment in NMOSD, which was reported recently in 2022. In addition, it was reported that there is no impact on the efficacy of inebilizumab between cases with and without pre–use of rituximab. It is observed that the inebilizumab treatment could reduce the dose of prednisolone and other preventive medicine rapidly and improve some psychiatric and metabolic symptoms.