There are 3 FDA-approved therapies now available to the NMOSD community. The Sumaira Foundation is pleased to share the first-of-its-kind, NMOSD Therapies Chart.
Our goal in laying out these new and available therapies side-by-side is to empower the patient community to discuss their treatment options with their doctors to make informed decisions about their best paths forward. At TSF, we’re strong advocates for shared decision-making between patients and their physicians, especially when it comes to deciding what long-term treatment(s) to opt for.
This chart has been created by TSF. Our Foundation works with therapy makers equally with an unbiased and objective lens.
Special thanks to Dr. Michael Levy (subject-matter expert), Andrea Sydney (volunteer project manager), and 3Dcubed (animator) for their support in bringing this chart to fruition.
– Animated video for explanation – Definition in text and audio format
Pharmacology
Pharmacology refers to how the therapy interacts with the body.
Drug Delivery Method
Soliris and Uplizna are administered to patients via infusions. Infusions start with a placement of an intravenous catheter in the arm. A bag/bottle of medicine is connected to the IV through tubing and a pump helps to push the medication into the circulation. At the conclusion of the infusion the catheter is removed. Enspryng is administered via injection, which is a single shot, using a short needle.
Frequency
How often the therapy needs to be administered.
Dosage
The amount of medication that is administered in each session.
Reduction in Relapse Risk
Reduction in risk of relapse is the chance that the medication will prevent all future relapses. 100% would be a cure. 0% would mean it doesn’t work at all.
Background Therapy
Background therapy is additional treatment that patients were allowed to use during the trial. These included off-label medications like prednisone or azathioprine. In this case, satralizumab was slightly more effective when combined with other treatments.
Antibody Criteria
Patients with NMO are classified into 3 categories: AQP4, MOG or double seronegative. AQP4 = aquaporin-4. MOG = myelin oligodendrocyte glycoprotein. AQP4 and MOG are the proteins in the spinal cord and optic nerve that the immune system is targeting. In NMO, the immune system is targeting one of these proteins and antibodies so AQP4 or MOG should be detectable in the blood. A few patients have neither antibody. The AQP4 antibody was discovered in 2004 and the trials were designed for this patient population.
AQP4+ (MOG untested)
This trial required AQP4 antibody testing to be positive to enroll. Since AQP4 patients do not have MOG antibodies, MOG was untested. The FDA only approved Soliris for AQP4 positive patients.
AQP4+ (MOG untested)
This trial enrolled more than 200 patients with AQP4, and only a small number of AQP4 negative patients, a few of whom had MOG (unpublished so far) and some were double seronegative. The FDA only approved Uplizna for AQP4 patients.
AQP4+ (MOG untested)
This trial was 1/3rd negative for the AQP4 antibody but it was not revealed how many were MOG antibody positive. The trial was unsuccessful for those who were AQP4 negative. The FDA only approved Enspryng for AQP4 positive patients.
Vaccinations
A vaccination, usually administered by injection, is formulated to protect individuals against a specific illness.
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