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August 2018; 8 (4) The Nerve! Readers Speak

Reader Response: Practice Current: How do you treat neuromyelitis optica?

Jagannadha Avasarala
First published August 13, 2018, DOI: https://doi.org/10.1212/CPJ.0000000000000497
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A few lingering questions on this topic.1

  1. I find it strange that Ocrevus, a CD20 blocker, is akin to Rituxan but not even on the map for treatment of neuromyelitis optica spectrum disorder (NMOSD), although Rituxan has been extensively used for this disease.

  2. What is double-negative (Ab) NMOSD? Does it exist?

  3. One hopes that there are better guidelines for monitoring CD19 cell counts (how frequent, endpoints, pitfalls, variations between end-stage disease and early-onset disease, if any).

  4. Pregnancy vs disease-modifying drugs in NMOSD is characterized by paucity of data. We need better data. Also, data collected will hopefully be openly shared among researchers so that there are many minds working on the same topic instead of a select few.

Footnotes

  • Author disclosures are available upon request (ncpjournal{at}neurology.org).

  • See response

References

  1. 1.↵
    1. Ganesh A
    . Practice Current: how do you treat neuromyelitis optica? Neurol Clin Pract 2017;7:170–178.
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