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Abstract Details

FDA Approved Treatments for Neuromyelitis Optica Spectrum Disorder in Clinical Practice: A Survey of Academic Neuroimmunologists
Autoimmune Neurology
P1 - Poster Session 1 (9:00 AM-5:00 PM)
003

To assess utilization and barriers to use of three recently FDA-approved treatments for neuromyelitis optica spectrum disorder (NMOSD) by academic neuroimmunologists.
Since 2019, eculizumab, inebilizumab, and satralizumab have received FDA approval for the treatment of aquaporin-4 IgG positive (AQP4+) NMOSD after showing efficacy in reducing attack frequency. However, little is known regarding the adoption of these therapies into practice or barriers to their use. We conducted a survey of academic neuroimmunologists to identify current treatment practices.
An electronic survey study was conducted of US neuroimmunologists. Recipients were identified on department websites of university-associated hospitals with affiliated neurology residencies. The survey was administered via email, and included questions regarding clinical background, patient cohort, treatment use in different scenarios, and barriers. The authors were blinded to the identity of respondents.
383 neuroimmunologists from 105 institutions were identified, of whom 33 from 18 states completed the survey. Nearly all (88%) reported treating patients with the newly FDA-approved therapies (NFTs). None reported discomfort discussing any NFT with their patients. Respondents reported uncommonly switching clinically stable patients to NFTs (69% never switch, 22% switch 1-25% of the time). For newly diagnosed AQP4+ NMOSD patients, NFT initiation rates varied (16% initiate none, 42% 1-25% of the time, 6.5% 25-50%, 19% 50-75%, 16% 75-100%). For patients with a relapse, responses were dichotomized regarding switching to NFTs - respondents either switch 75-100% of their patients (60%) or none or 1-25% (16%, 24% respectively). Nearly half (16/33) of respondents reported being unable to start NFTs, with insurance/cost issues being the most cited barrier.
Among academic neuroimmunologists, FDA-approved therapies for AQP4+ NMOSD are being utilized for newly diagnosed patients and those with disease recurrence, although individual practice patterns vary. The main perceived barriers to NFT use are insurance/cost-related issues.
Authors/Disclosures
Robert J. Sharkus III, DO
PRESENTER 		Dr. Sharkus has nothing to disclose.
Jesse Thon, MD (Cooper University Hospital) An immediate family member of Dr. Thon has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Horizon. An immediate family member of Dr. Thon has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. An immediate family member of Dr. Thon has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Genentech.
Richa Thakkar, DO Dr. Thakkar has nothing to disclose.
No disclosure on file
James E. Siegler III, MD (University of Chicago) Dr. Siegler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Siegler has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Bayer. Dr. Siegler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Serb. Dr. Siegler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ceribell. Dr. Siegler has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Wallaby Phenox. Dr. Siegler has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Stroke: Vascular and Interventional Neurology. Dr. Siegler has received personal compensation in the range of $50,000-$99,999 for serving as an Expert Witness for Precision Medicine, LLC. The institution of Dr. Siegler has received research support from Philips. The institution of Dr. Siegler has received research support from Medtronic.
No disclosure on file