Overview of treatment of NMO

Abstract

AbstractRecent studies has shown that neuromyelitis optica (NMO) is clearly a different disease compared with multiple sclerosis (MS). Several MS drugs may increase inflammation process in NMO, especially interferon beta, natalizumab and fingolimod. This fact has 2 important consequences : First the diagnosis of NMO has to been done as soon as possible in order to differentiate NMO and MS patients. Second, as NMO is an antibody mediated disease immunosuppressive grugs should be proposed if the diagnosis is done. First step therapy is based on azathioprine, mycophenolate mofetil and methotrexate. Second step therapy are Rituximab, cyclophosphamide and mitoxantrone. Several drugs (with atarget on complement subunites or several cytokine, especially IL6 or IL17) are currently tested in phase II or III trials. Symptomatic treatments directed against fatigue, urinary or bowel dysfunctions, pain remains also of importance. Commercial interest