Treatment of relapses in neuromyelitis optica spectrum disorders

Česká verzia

Authors: P. Hradílek
Authors place of work: Neurologická klinika FN Ostrava
Published in the journal: Cesk Slov Neurol N 2020; 83/116(supplementum 1): 58-61
doi: https://doi.org/10.14735/amcsnn2020S58

Summary

Treatment of neuromyelitis optica spectrum disorders (NMOSD) relapses should be always urgent and consistent, because the majority of accumulation of neurological disability occurs just during relapses. The first-choice therapy is usually high-dose methylprednisolon followed by oral taper of steroids. In case of its failure elimination methods (therapeutic plasma exchange or immunoadsorption) are usually used. These methods can be also used as first choice therapy in case of severe relapse or if they had a positive effect on previous relapses in treated patient. In case of failure of elimination methods, administration of cyclophosphamid could be considered. Recently, several clinical trials with new drugs for acute relapses of NMO/NMOSD with highly specific mode of action have been conducted, however use of these drugs is still only experimental and its possible use in common clinical practice is awaited.

Keywords:

IVIG – NMO/NMOSD relapse – corticosteroids – elimination methods – cytoablative treatment – new therapeutic options

Zdroje

1. Wingerchuk DM, Hogancamp WF, O_Brien PC et al. The clinical course of neuromyelitis optica (Devic_s syndrome). Neurology 1999; 53 (5): 1107–1114. doi: 10.1212/wnl.53.5.1107.

2. Wingerchuk DM, Weinshenker BG. Neuromyelitis optica: clinical predictors of a relapsing course and survival. Neurology 2003; 60 (5): 848–853. doi: 10.1212/01.wnl.0000049912.02954.2c.

3. Sellner J, Boggild M, Clanet M et al. EFNS guidelines on diagnosis and management of neuromyelitis optica. Eur J Neurol 2010; 17 (8): 1019–1032. doi: 10.1111/j.1468-1331.2010.03066.x.

4. Nytrová P, Horáková D. Neuromyelitis optica. Cesk Slov Neurol N 2015; 78/111 (2): 130–137. doi: 10.14735/amcsnn2015130

5. McCreary M, Mealy MA, Wingerchuk DM et al. Updated diagnostic criteria for neuromyelitis optica spectrum disorder: Similar outcomes of previously separate cohorts. Mult Scler J Exp Transl Clin 2018; 4 (4): 205521731881592. doi: 10.1177/2055217318815925.

6. Kimbrough JD, Fujihara K, Jacob A et al. Treatment of neuromyelitis optica: review and recommendations. Mult Scler Relat Disord 2012; 1 (4): 180–187. doi: 10.1016/j.msard.2012.06.002.

7. Bruscolini A, Sacchetti M, La Cava M et al. Diagnosis and management of neuromyelitis optica spektrum disorders – an update. Autoimmun Rev 2018; 17 (3): 195–200. doi: 10.1016/j.autrev.2018.01.001.

8. Llufriu S, Castillo J, Blanco Y et al. Plasma exchange for acute attacks of CNS demyelination: predictors of improvement at 6 months. Neurology 2009; 73 (12): 949–953. doi: 10.1212/WNL.0b013e3181b879be.

9. Watanabe S, Nakashima I, Misu T et al. Therapeutic efficacy of plasma exchange in NMO-IgG-positive patients with neuromyelitis optica. Mult Scler 2007; 13 (1): 128–132. doi: 10.1177/1352458506071174.

10. Chalmoukou K, Alexopoulos H, Akrivou S et al. Anti-MOG antibodies are frequently associated with steroid-sensitive recurrent optic neuritis. Neurol Neuroimmunol Neuroinflamm 2015; 2 (4): e131. doi: 10.1212/NXI.0000 000000000131

11. Narayan R, Simpson A, Fritsche K et al. MOG antibody disease: a review of MOG antibody seropositive neuromyelitis optica spectrum disorder. Mult Scler Relat Disord 2018; 25: 66–72. doi: 10.1016/j.msard.2018.07.025.

12. Matic G, Bosch T, Ramlow W. Background and indications for protein A-based extracorporeal immunoadsorption. Ther Apher 2001; 5 (5): 394–403. doi: 10.1046/j.1526-0968.2001.00370.x.

13. Staudt A, Dorr M, Staudt Y et al. Role of immunoglobulin G3 subclass in dilated cardiomyopathy: results from protein A immunoadsorption. Am Heart J 2005; 150 (4): 729–736. doi: 10.1016/j.ahj.2004.11.002.

14. Baggi F, Ubiali F, Nava S et al. Eﬀect of IgG immunoadsorption on serum cytokines in MG and LEMS patients. J Neuroimmunol 2008; 201–202: 104–110. doi: 10.1016/j.jneuroim.2008.05.026.

15. Bulut D, Creutzenberg G, Mugge A. The number of regulatory T cells correlat es with hemodynamic improvement in patients with inﬂammatory dilated cardiomyopathy after immunoadsorption therapy. Scand J Immunol 2013; 77 (1): 54–61. doi: 10.1111/sji.12000.

16. Kessler RA, Mealy MA, Levy M. Treatment of neuromyelitis optica spectrum disorder: acute, preventive, and symptomatic. Curr Treat Options Neurol 2016; 18 (1): 2. doi: 10.1007/s11940-015-0387-9

17. Bonnan M, Valentino R, Olindo S et al. Plasma exchange in severe spinal attacks associated with neuromyelitis optica spectrum disorder. Mult Scler 2009; 15 (4): 487–492. doi: 10.1177/1352458508100837.

18. Weinshenker BG, O’Brien PC, Petterson TM et al. A randomized trial of plasma exchange in acute central nervous system inflammatory demyelinating disease. Ann Neurol 1999; 46 (6): 878–886. doi: 10.1002/1531-8249 (199912) 46: 6<878:: aid-ana10>3.0.co; 2-q.

19. Abboud H, Petrak A, Mealy M et al. Treatment of acute relapses in neuromyelitis optica: steroids alone versus steroids plus plasma exchange. Mult Scler 2016; 22 (2): 185–192. doi: 10.1177/1352458515581438.

20. Trebst C, Jarius S, Berthele A et al. Update on the diag-nosis and treatment of neuromyelitis optica: Recommendations of the Neuromyelitis Optica Study Group (NEMOS). J Neurol 2014; 261 (1): 1–16. doi: 10.1007/s00415-013-7169-7.

21. Bonnan M, Valentino R, Olindo S et al. Plasma exchange in severe spinal attacks associated with neuromyelitis optica spectrum disorder. Mult Scler 2009; 15: 487–492

22. Magan˜a SM, Keegan BM, Weinshenker BG et al. Beneficial plasma exchange response in central nervous systém inflammatory demyelination. Arch Neurol 2011; 68 (7): 870–878. doi: 10.1001/archneurol.2011.34.

23. Bonnan M, Cabre P. Plasma exchange in severe attacks of neuromyelitis optica. Mult Scler Int 2012; 2012: 787630. doi: 10.1155/2012/787630.

24. Weinshenker BG, O’Brien PC, Petterson TM et al. A randomized trial of plasma exchange in acute central nervous system inflammatory demyelinating disease. Ann Neurol 1999; 46 (6): 878–886. doi: 10.1002/1531-8249 (199912) 46: 6<878:: aid-ana10>3.0.co; 2-q.

25. Nakashima I, Takahashi T, Nishiyama S et al. Plasma Exchange for neuromyelitis optica with aquaporin-4 antibody. Neurology 2009; 72: A187

26. Abboud H, Petrak A, Mealy M et al. Treatment of acute relapses in neuromyelitis optica: steroids alone versus steroids plus plasma exchange. Mult Scler 2016; 22 (2): 185–192. doi: 10.1177/1352458515581438.

27. Kleiter I, Gahlen A, Borisow N et al. Apheresis therapies for NMOSD attacks: a retrospective study of 207 therapeutic interventions. Neurol Neuroimmunol Neuroinflamm 2018; 5 (6): e504. doi: 10.1212/NXI.0000000000000504.

28. Nozaki I, Hamaguchi T, Komai K et al. Fulminant Devic disease successfully treated by lymphocytapheresis. J Neurol Neurosurg Psychiatry 2006; 77 (9): 1094–1095. doi: 10.1136/jnnp.2005.086306.

29. Elsone L, Panicker J, Mutch K et al. Role of intravenous immunoglobulin in the treatment of acute relapses of neuromyelitis optica: experience in 10 patients. Mult Scler 2014; 20 (4): 501–504. doi: 10.1177/1352458513495938.

30. Greenberg BM, Thomas KP, Krishnan C et al. Idiopathic transverse myelitis: corticosteroids, plasma exchange, or cyclophosphamide. Neurology 2007; 68 (19): 1614–1617. doi: 10.1212/01.wnl.0000260970.63493.c8.

31. Yaguchi H, Sakushima K, Takahashi I et al. Efficacy of intravenous cyclophosphamide therapy for neuromyelitis optica spectrum disorder. Intern Med 2013; 52 (9): 969–972. doi: 10.2169/internalmedicine.52.7885

32. Jones MV, Fox-Talbot K, Levy M. Evidence for classic complement activity in neuromyelitis optica. Clin Neuropathol 2014; 33 (3): 251–252. doi: 10.5414/NP300697.

33. Nytrova P, Potlukova E, Kemlink D et al. Complement activation in patients with neuromyelitis optica. J Neuroimmunol 2014; 274 (1–2): 185–191. doi: 10.1016/j.jneuroim.2014.07.001.

34. Levy M, Mealy MA. Purified human C1-esterase inhibitor is safe in acute relapses of neuromyelitis optica. Neurol Neuroimmunol Neuroinflamm 2014; 1 (1): e5. doi: 10.1212/NXI.0000000000000005.

35. Thompson EM, Frenkel EP, Neuwelt EA. The paradoxical effect of bevacizumab in the therapy of malignant gliomas. Neurology 2011; 76 (1): 87–93. doi: 10.1212/WNL.0b013e318204a3af.

36. Argaw AT, Asp L, Zhang J et al. Astrocyte-derived VEGF-A drives blood-brain barrier disruption in CNS inflammatory disease. J Clin Invest 2012; 122 (7): 2454–2468. doi: 10.1172/JCI60842.

37. Mealy MA, Shin K, John G et al. Bevacizumab is safe in acute relapses of neuromyelitis optica. Clin Exp Neuroimmunol 2015; 6 (4): 413–418. doi: 10.1111/cen3.12239.

38. Herges K, de Jong BA, Kolkowitz I et al. Protective effectof an elastase inhibition in a neuromyelitis optica-likedisease driven by a peptide of myelin oligodendroglial glycoprotein. Mult Scler 2012; 18 (4): 398–408. doi: 10.1177/1352458512440060.

39. Saadoun S, Waters P, MacDonald C et al. Neutrophil protease inhibition reduces neuromyelitis optica-immu-noglobulin G-induced damage in mouse brain. Ann Neurol 2012; 71 (3): 323–333. doi: 10.1002/ana.22686.

40. Araki M, Yamamura T. Neuromyelitis optica spectrum disorders: emerging therapies. Clin Exp Neuroimmunol 2017; 8 (2): 107–116. doi: 10.1111/cen3.12394

41. Zhang H, Verkman AS. Eosinophil pathogenicity mecha-nisms and therapeutics in neuromyelitis optica. J ClinInvest 2013; 123 (5): 2306–2316. doi: 10.1172/JCI67554.

42. Kleiter I, Gahlen A, Borisow N et al. Neuromyelitis optica: evaluation of 871 attacks and 1,153 treatment courses. Ann Neurol 2016; 79 (2): 206–216. doi: 10.1002/ana.24554.