Treatments

Treatments for Neuromyelitis Optica Spectrum Disorder

Treatment for NMOSD can stop attacks and lower the risk of future attacks. There is currently no cure for NMOSD.

Steroids

During an attack, high-dose steroids are usually given through a vein. These medications reduce inflammation by calming the immune system. If symptoms are severe or do not improve enough, other options may be used, including:

• Plasma exchange – replacing part of the blood with specialized fluids
• Intravenous immunoglobulin (IVIG) – proteins that dampen the immune system

Some patients need steroids to be reduced slowly, because symptoms can return if treatment is stopped too quickly.

Long-term medications

Because NMOSD symptoms often return, long-term treatment is generally recommended to prevent attacks. For adults with AQP4 antibodies, medications approved by the U.S. Food and Drug Administration (FDA) include eculizumab, inebilizumab, satralizumab and ravulizumab. Other medications, such as rituximab, mycophenolate mofetil or azathioprine, may also be used.

These medications affect the immune system in different ways and can raise the risk of infection. Your specialist will choose a treatment based on your AQP4 test, health, pregnancy plans, other medications and personal goals. Vaccines or other safety steps may be needed before treatment.