Abstract Details

NMOSD is a rare autoimmune neuroinflammatory disease that primarily affects the optic nerves and spinal cord and can lead to sensory/motor impairment, vision loss and permanent neurological disability. The US FDA approved satralizumab for use in adult patients with AQP4-IgG+ NMOSD in 2020, but real-world data are limited.

To describe the response to satralizumab in adult patients with aquaporin 4 autoantibody–positive (AQP4-IgG+) neuromyelitis optica spectrum disorder (NMOSD) in clinical practice.

To date, 16 patients aged 23-74 years and of multiple races and ethnicities are included. Most patients are female; approximately half have autoimmune comorbidities. NMOSD disease duration ranged from <1-14 years; symptoms included optic neuritis and transverse myelitis. More than half of patients received immunosuppressants other than corticosteroids (most commonly mycophenolate mofetil) or disease-modifying therapies (most commonly rituximab) for NMOSD before satralizumab, with reasons for switch including treatment intolerance and inadequate disease control. To date, patients received satralizumab for 7-21 months, either as monotherapy or in combination with immunosuppressants. Fifteen patients were relapse free with satralizumab, despite reports of confirmed or suspected relapses with previous treatments in some patients. Overall, patients maintained disease control, with few adverse events reported (leukopenia being the most common). No patients permanently discontinued satralizumab due to ineffectiveness or intolerance.