Treatment of neuromyelitis optica: an evidence based review

Arquivos de Neuro-Psiquiatria - Tập 70 Số 1 - Trang 59-66 - 2012
Douglas Kazutoshi Sato1, Dagoberto Callegaro2, Marco Aurélio Lana–Peixoto3, Kazuo Fujihara4
1Tohoku University Sendai, Japan#TAB#
2University of São Paulo, Brazil
3Federal University of Minas Gerais, Belo Horizonte, Brazil
4Tohoku University Graduate School of Medicine, Sendai, Japan

Tóm tắt

Neuromyelitis optica (NMO) is an inflammatory disease of the central nervous system characterized by severe optic neuritis and transverse myelitis, usually with a relapsing course. Aquaporin-4 antibody is positive in a high percentage of NMO patients and it is directed against this water channel richly expressed on foot processes of astrocytes. Due to the severity of NMO attacks and the high risk for disability, treatment should be instituted as soon as the diagnosis is confirmed. There is increasing evidence that NMO patients respond differently from patients with multiple sclerosis (MS), and, therefore, treatments for MS may not be suitable for NMO. Acute NMO attacks usually are treated with high dose intravenous corticosteroid pulse and plasmapheresis. Maintenance therapy is also required to avoid further attacks and it is based on low-dose oral corticosteroids and non-specific immunosuppressant drugs, like azathioprine and mycophenolate mofetil. New therapy strategies using monoclonal antibodies like rituximab have been tested in NMO, with positive results in open label studies. However, there is no controlled randomized trial to confirm the safety and efficacy for the drugs currently used in NMO.

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Arquivos de Neuro-Psiquiatria

Tập 70 Số 1

59-66

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