NMOSD is a chronic, autoimmune disease characterized by recurrent attacks on the central nervous system causing permanent neurological damage and cumulative disability impacting health-related quality of life. Previously, a MAIC using committee adjudicated attacks provided a robust and rigorous trial comparison of two current NMOSD therapies, inebilizumab and satralizumab, supporting an informed evidence-based therapy decision.

An anchored MAIC compared the relative efficacy of inebilizumab to eculizumab and satralizumab based on published data from randomized control trials in adults with aquaporin-4 seropostive (AQP4+) NMOSD. Estimates were expressed as the relative risks of experiencing an NMOSD attack based on time to first IAA with the N-MOmentum inebilizumab AQP4+ population compared to each treatment. Subsequently, based on the calculated relative risks, a model was built to estimate long term effectiveness presented as life years and quality-adjusted life years. The model simulated NMOSD-related mortality based on disease progression.  

The relative risk (RR [CI]) of experiencing an NMOSD attack with inebilizumab compared to eculizumab and satralizumab were 1.51 [0.70, 3.25], and 0.49 [0.19, 1.28] respectively. The calculated life years demonstrated an advantage for inebilizumab (21.90) compared with eculizumab (16.02) and satralizumab (20.79). Similarly, the quality adjusted life years shown and advantage for inebilizumab (12.55) compared with eculizumab (8.23) and satralizumab (11.34).

Utilizing IAA for analysis of relative risk for NMOSD attack showed stronger results for treatment with inebilizumab than previously reported. Additionally, treatment with inebilizumab yields better results for expected life years and quality adjusted life years compared to either satralizumab or eculizumab. Relative efficacy and discontinuation were the key drivers of the results.