教育講演
中枢神経炎症性脱髄疾患の最近の進歩
キーワード:
multiple sclerosis,
neuromyelitis optica,
monoclonal antibodies,
disease modifying drugs,
high efficacy treatments
2023 年 40 巻 4 号 p. 438-440
詳細
2023 年 40 巻 4 号 p. 438-440
Central nervous system (CNS) inflammatory demyelinating diseases include multiple sclerosis (MS), neuromyelitis optica spectrum disorders (NMOSD), myelin oligodendrocyte glycoprotein antibody–associated disorders (MOGAD). Regarding to treatments for these diseases, a series of drugs have been approved for MS and NMOSD in recent years.
In MS, the increasing number of disease–modifying drugs (DMDs) has led to a change in the treatment algorithm, with high efficacy treatments (HET) now recommended as the first line of treatment. In Japan, natalizumab and ofatumumab are considered to be classified as HETs among DMDs approved in Japan, and treatment initiation from these HETs has been increasing in Japan. In NMOSD, four biologics have been approved successively in the last three years, enabling steroid–free prevention of relapse, whereas previously prednisolone was the mainstay of relapse prevention. On the other hand, the increase in treatment options requires more expertise and experience to implement optimal treatment.
