- Department of Ophthalmology, PLA General Hospital, Beijing 100853, China;
Neuromyelitis optica spectrum disorder (NMOSD) is a kind of demyelinating disease of central nervous system which mainly affect optic nerve and spinal cord. Because of its serious blindness and disability, how to effectively prevent relapse has become the focus of ophthalmologists. With the deep understanding of the pathogenesis and the progress of scientific and technological means, more and more monoclonal antibodies(mAb) continue to enter clinical trials. B cell surface antigen CD20 blocker, rituximab, has become a first-line drug for the treatment of NMOSD. CD19 blocker, inebilizumab, can reduce the recurrence and disability of NMOSD patients. The addition of interleukin 6 receptor blocker, satralizumab, and complement C5 inhibitor, eculizumab, reduce the recurrence. Some mAbs such as natalizumab and alemtuzumab may not be effective for the treatment of NMOSD. The expansion of mAb treatment indications and the launch of new drugs still require more clinical trials which are large-scale and international cooperation. At the same time, its potential adverse events and cost issues cannot be ignored.
Citation: Fu Junxia, Wei Shihui. The progress in clinical applications of monoclonal antibodies in the treatment of neuromyelitis optica spectrum disorder. Chinese Journal of Ocular Fundus Diseases, 2021, 37(3): 240-244. doi: 10.3760/cma.j.cn511434-20200728-00357 Copy
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- 8. Asavapanumas N, Ratelade J, Verkman AS. Unique neuromyelitis optica pathology produced in naïve rats by intracerebral administration of NMO-IgG[J]. Acta Neuropathol, 2014, 127(4): 539-551. DOI: 10.1007/s00401-013-1204-8.
- 9. Ratelade J, Asavapanumas N, Ritchie AM, et al. Involvement of antibody-dependent cell-mediated cytotoxicity in inflammatory demyelination in a mouse model of neuromyelitis optica[J]. Acta Neuropathol, 2013, 126(5): 699-709. DOI: 10.1007/s00401-013-1172-z.
- 10. Chihara N, Aranami T, Sato W, et al. Interleukin 6 signaling promotes anti-aquaporin 4 autoantibody production from plasmablasts in neuromyelitis optica[J]. Proc Natl Acad Sci USA, 2011, 108(9): 3701-3706. DOI: 10.1073/pnas.1017385108.
- 11. Kimura A, Kishimoto T. IL-6: regulator of Treg/Th17 balance[J]. Eur J Immunol, 2010, 40(7): 1830-1835. DOI: 10.1002/eji.201040391.
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- 14. Cree BA, Lamb S, Morgan K, et al. An open label study of the effects of rituximab in neuromyelitis optica[J]. Neurology, 2005, 64(7): 1270-1272. DOI: 10.1212/01.WNL.0000159399.81861.D.
- 15. Jacob A, Weinshenker BG, Violich I, et al. Treatment of neuromyelitis optica with rituximab: retrospective analysis of 25 patients[J]. Arch Neurol, 2008, 65(11): 1443-1448. DOI: 10.1001/archneur.65.11.noc80069.
- 16. Shaygannejad V, Fayyazi E, Badihian S, et al. Long-term tolerability, safety and efficacy of rituximab in neuromyelitis optica spectrum disorder: a prospective study[J]. J Neurol, 2019, 266(3): 642-650. DOI: 10.1007/s00415-019-09180-9.
- 17. Ip VH, Lau AY, Au LW, et al. Rituximab reduces attacks in Chinese patients with neuromyelitis optica spectrum disorders[J]. J Neurol Sci, 2013, 324(1-2): 38-39. DOI: 10.1016/j.jns.2012.09.024.
- 18. Zéphir H, Bernard-Valnet R, Lebrun C, et al. Rituximab as first-line therapy in neuromyelitis optica: efficiency and tolerability[J]. J Neurol, 2015, 262(10): 2329-2335. DOI: 10.1007/s00415-015-7852-y.
- 19. Li T, Zhang LJ, Zhang QX, et al. Anti-rituximab antibody in patients with NMOSDs treated with low dose rituximab[J]. J Neuroimmunol, 2018, 316: 107-111. DOI: 10.1016/j.jneuroim.2017.12.021.
- 20. Lu Q, Luo J, Hao H, et al. A long-term follow-up of rituximab treatment in 20 Chinese patients with neuromyelitis optica spectrum disorders[J/OL]. Mult Scler Relat Disord, 2020, 40: 101933[2020-01-05]. https://pubmed.ncbi.nlm.nih.gov/31955136/. DOI: 10.1016/j.msard.2020.101933.
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- 23. Damato V, Evoli A, Iorio R. Efficacy and safety of rituximab therapy in neuromyelitis optica spectrum disorders: a systematic review and meta-analysis[J]. JAMA Neurol, 2016, 73(11): 1342-1348. DOI: 10.1001/jamaneurol.2016.1637.
- 24. Tahara M, Oeda T, Okada K, et al. Safety and efficacy of rituximab in neuromyelitis optica spectrum disorders (RIN-1 study): a multicentre, randomised, double-blind, placebo-controlled trial[J]. Lancet Neurol, 2020, 19(4): 298-306. DOI: 10.1016/S1474-4422(20)30066-1.
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- 26. Ciron J, Audoin B, Bourre B, et al. Recommendations for the use of rituximab in neuromyelitis optica spectrum disorders[J]. Rev Neurol (Paris), 2018, 174(4): 255-264. DOI: 10.1016/j.neurol.2017.11.005.
- 27. Zhang M, Zhang C, Bai P, et al. Effectiveness of low dose of rituximab compared with azathioprine in Chinese patients with neuromyelitis optica: an over 2-year follow-up study[J]. Acta Neurol Belg, 2017, 117(3): 695-702. DOI: 10.1007/s13760-017-0795-6.
- 28. Yang CS, Yang L, Li T, et al. Responsiveness to reduced dosage of rituximab in Chinese patients with neuromyelitis optica[J]. Neurology, 2013, 81(8): 710-713. DOI: 10.1212/WNL.0b013e3182a1aac7.
- 29. 魏世辉, 宋宏鲁. 增强对视神经脊髓炎相关性视神经炎的认识, 提高早期正确诊断及治疗水平[J]. 中华眼底病杂志, 2019, 35(3): 215-218. DOI: 10.3760/cma.j.issn.1005-1015.2019.03.001.Wei SH, Song HL. Enhance the awareness of neuromyelitis optica-related optic neuritis to improve early diagnosis and treatment outcomes[J]. Chin J Ocul Fundus Dis, 2019, 35(3): 215-218. DOI: 10.3760/cma.j.issn.1005-1015.2019.03.001.
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