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Are corticosteroids or monoclonal antibodies better to prevent relapse in NMO spectrum disorders?
Evidence for the treatment of neuromyelitis optica (NMO) spectrum disorder (NMOSD) has accumulated in the past decades. Case series and open-label studies suggest the efficacy of various immunosuppressive agents and more recently, monoclonal antibodies for attack prevention. Oral corticosteroids combined with azathioprine, mycophenolate mofetil or rituximab are an efficient widely used treatment.1 However, because of the lack of randomised controlled trials (RCT) to evaluate the efficacy and safety of any drugs described above, there is no established therapy.
In their JNNP paper,Stellmann et al2 (German NEMOS (Neuromyelitis Optica Study) Group) reported a retrospective cohort study, including 150 patients with NMOSD (87% aquaporin-4 antibody positive), for attack prevention therapies …