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Review
. 2022 Apr 9;23(8):4154.
doi: 10.3390/ijms23084154.

Adverse Events in NMOSD Therapy

Katrin Giglhuber  1 , Achim Berthele  1
Affiliations
Review

Adverse Events in NMOSD Therapy

Katrin Giglhuber et al. Int J Mol Sci. .

Abstract

Neuromyelitis optica spectrum disorders (NMOSD) are rare neurologic autoimmune diseases that have a poor prognosis if left untreated. For many years, generic oral immunosuppressants and repurposed monoclonal antibodies that target the interleukin-6 pathway or B cells were the mainstays of drug treatment. Recently, these drug treatments have been complemented by new biologics developed and approved specifically for NMOSD. In principle, all of these drugs are effective, but treatment recommendations that take this into account are still pending. Instead, the choice of a drug may depend on other criteria such as drug safety or tolerability. In this review, we summarise current knowledge on the adverse effects of azathioprine, mycophenolate mofetil, rituximab, tocilizumab, eculizumab, satralizumab, and inebilizumab in NMOSD. Infections, cytopenias, and infusion-related reactions are most common, but the data are as heterogeneous as the manifestations are diverse. Nevertheless, knowledge of safety issues may facilitate treatment choices for individual patients.

Keywords: adverse events; eculizumab; immunosuppressants; inebilizumab; neuromyelitis optica spectrum diseases; rituximab; safety profile; satralizumab; tocilizumab.

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Conflict of interest statement

Katrin Giglhuber declares no conflict of interest. Achim Berthele has received speaker and consulting honoraria from Alexion, Biogen, Bayer Healthcare, Celgene, Merck, Novartis Pharma, and Roche, all outside the submitted work. His institution has received compensations from Alexion AstraZeneca Rare Disease Pharmaceuticals, Inc. for participation in the PREVENT and CHAMPION-NMO trials.

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