Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Neurotherapeutics. 2021 Jul;18(3):1623-1636. doi: 10.1007/s13311-021-01055-0. Epub 2021 Apr 28.
Advances in neuromyelitis optica spectrum disorder pathogenesis have allowed the development of targeted drugs. These treatments act on core elements of the disease, including the pro-inflammatory IL-6 pathway (tocilizumab and satralizumab), B cells (rituximab and inebilizumab), and complement (eculizumab). According to recent phase II-III trials, biologics significantly reduced the risk of relapses in aquaporin-4-seropositive patients, whereas results were less striking in the small cohorts of aquaporin-4-seronegative patients. Most adverse events were mild to moderate, with systemic symptoms (headache, arthralgia) or infections (upper respiratory and urinary tracts) being most commonly reported.
神经髓鞘炎谱系疾病发病机制的研究进展使得靶向药物得以开发。这些治疗方法针对疾病的核心要素，包括促炎的白细胞介素-6 通路（托珠单抗和 satralizumab）、B 细胞（利妥昔单抗和 inebilizumab）和补体（依库珠单抗）。根据最近的 II 期-III 期试验，生物制剂显著降低了水通道蛋白-4 阳性患者的复发风险，而在水通道蛋白-4 阴性患者的小队列中，结果则不那么显著。大多数不良事件为轻度至中度，最常报告的是全身症状（头痛、关节痛）或感染（上呼吸道和泌尿道）。
