New regulatory-approved medications should be used exclusively for prevention of attacks of NMOSD over currently used non-regulatory approved medications.
Capsule: It is likely that 3 immunomodulatory treatments, a C5 complement inhibitor, an anti-CD19 monoclonal antibody and an inhibitor of IL6 receptor, will all receive regulatory approval for treatment of NMOSD. Do these drugs offer sufficient advantages that they should replace currently used immunotherapies that are widely regarded as effective and are less expensive?
17:00-17:20
Yes: Orhan Aktas, Germany
17:20-17:40
No: Andrzej Glabinski, Poland
17:40-17:50
Discussion and rebuttals
17:50-18:40
NMOSD attacks should be treated with apheresis/plasma exchange at first presentation, either with or without corticosteroids.
Capsule: Recent experience suggests that concomitant or first line treatment with plasma exchange may be superior to treatment with corticosteroids. Is a change in the standard approach of using corticosteroids first appropriate, given the current state of knowledge?
17:50-18:10
Yes: Romain Marignier, France
18:10-18:30
Steroids still should be used first: Maria Isabel Leite, UK
18:30-18:40
Discussion and rebuttals
18:40-19:30
The 2015 International Panel criteria for NMOSD are outdated and should be replaced with a diagnostic classification based on autoantibody status rather than clinical presentation (i.e. AQP4 disease, MOG disease).
Capsule: We now know the molecular target of the autoimmune insult in the majority of patients with NMOSD, and molecular classification based on the target of the antibody can be used in lieu of clinical criteria for diagnosis of what we currently refer to as NMOSD. Are we ready for a molecular classification of NMOSD in 2020?
