Abstract Details

Title Combination of Cyclosporine A with Corticosteroids Is Effective for the Treatment of Neuromyelitis Optica

Topic MS and Related Diseases

Presentation(s) P02 - (-)

Poster/Presentation
Number 155

Objective

Background BACKGROUND: NMO/NMOSD is a neuroinflammatory disease primarily involving optic nerves and spinal cord, and frequently results in severe neurological disabilities by accumulating relapses. Therefore, reducing relapses is critical for preserving the neurological function in NMO/NMOSD patients.

Design/Methods DESIGN/METHODS: We retrospectively evaluated the efficacy of various immunosuppressants for NMO/NMOSDs by reviewing the clinical records of 52 patients confirmed as seropositive for anti-aquaporin 4 (AQP4) antibody, which is a specific biomarker for this disorder.

Results RESULTS: Of the 52 patients, 26 (23 women, 3 men) had received at least a kind of immunosuppressant other than corticosteroids. After eliminating ineligible cases, we evaluated the following 24 treatments in 22 patients (20 women, 2 men) that used azathioprine (AZA) [n = 9], cyclophosphamide [n = 1], cyclosporine A (CyA) [n = 9], tacrolimus [n = 2], methotrexate [n = 1], and mizoribine [n = 2]. Both AZA and CyA treatments allowed us to decrease the median dose of the co-administered prednisone without affecting the Expanded Disability Severity Scale (EDSS) scores. In patients with relapsing-remitting courses, the annual relapse rate (ARR) decreased from 1.7 (1.2-2.7) to 0.47 (0.36-0.59) after AZA treatments (n = 6, P = 0.028), and also showed a significant decrease from 2.7 (1.8-4.3) to 0.38 (0-0.97) after CyA treatment (n = 8, P = 0.012).

Conclusions CONCLUSIONS: These results indicate that CyA as well as AZA may help stabilize the disease activity in NMO/NMOSD patients seropositive for anti-AQP4 antibodies. This is the first case series study demonstrating the efficacy of CyA for the treatment of NMO/NMOSDs.

Authors/Disclosures
PRESENTER	No disclosure on file
Mika Komori	Mika Komori has received personal compensation for serving as an employee of Eli Lilly K.K..
	No disclosure on file
Akihiko Ozaki, MD, PhD (JCHO Yamato Koriyama Hospital)	No disclosure on file
	No disclosure on file
Ryosuke Takahashi, MD (Kyoto University Graduate School of Medicine)	Dr. Takahashi has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Kan Institute. Dr. Takahashi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Takeda Pharma. Dr. Takahashi has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Ono Pharma. Dr. Takahashi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Kyowa Kirin Pharma. Dr. Takahashi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Otsuka Pharma. Dr. Takahashi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Abbvie. Dr. Takahashi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Eisai. Dr. Takahashi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Chugai Pharma. Dr. Takahashi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alexion. Dr. Takahashi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Argenix. Dr. Takahashi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alnyrum. Dr. Takahashi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sumitomo Pharma. The institution of Dr. Takahashi has received research support from MEXT. Japan. The institution of Dr. Takahashi has received research support from AMED, Japan. The institution of Dr. Takahashi has received research support from JST, Japan. The institution of Dr. Takahashi has received research support from MHLW, Japan. The institution of Dr. Takahashi has received research support from Sumitomo Pharma. The institution of Dr. Takahashi has received research support from Takeda Pharma. The institution of Dr. Takahashi has received research support from Otsuka Pharma. Dr. Takahashi has received personal compensation in the range of $500-$4,999 for serving as a PO with AMED, Japan. Dr. Takahashi has received personal compensation in the range of $500-$4,999 for serving as a PO with JST, Japan.
	No disclosure on file
	No disclosure on file
Cynthia Carrillo Infante, MD, PhD	No disclosure on file
Takayuki Kondo, MD, PhD (Kansai Medical University Medical Center)	Prof. Kondo has nothing to disclose.

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