2023 Volume 40 Issue 3 Pages 397-400
Objective : Several biological drugs have been introduced as relapse prevention therapy for neuromyelitis optica spectrum disorders (NMOSD) in recent years, and cases introduced have been increasing owing to their high efficacy. In this report, we present the transition of relapse prevention treatment before and after the introduction of biologics.
Methods : Patients with NMOSD who visited our hospital were categorized into before– (2018–2019) and after–biologics (2020–2021) groups based on the launch of biologics. We retrospectively analyzed patients' data from their medical records.
Results : Before the market release of biologics, we encountered 18 patients with NMOSD (14 women, 4 men), mean age 58.3 years, mean disease duration 7.7 years, mean Expanded Disability Status Scale (EDSS) 4.8, and mean number of recurrences per year 0.4. Prednisolone (PSL) was administered to 13 patients (72.2%, mean dose 10.7 mg/day) and immunosuppressive drugs to 11 patients (61.1%) as recurrence preventive treatment. Following the market release of biologics, we encountered 27 patients with NMOSD (21 women, 6 men), mean age 54.9 years, mean disease duration 6.8 years, mean EDSS 4.2, and mean number of relapses per year 0.3. PSL was administered as recurrence preventive treatment to 23 patients (85.2%, mean dose 9.1 mg/day), immunosuppressive drugs to 12 patients (44.4%), and biologic agents to 7 patients (25.9%).
Conclusion : The introduction of biologics decreased the use of PSL and immunosuppressive agents, which decreased the EDSS and annual recurrence rates. Careful evaluation of the risks and benefits and appropriate patient selection are important for introduction of biologics.
