Abstract Details

Title Observational Study of Inebilizumab as a Salvage Therapy for Acute Optic Neuritis in Neuromyelitis Optica Spectrum Disorder (NMOSD-ON)

Topic Autoimmune Neurology

Presentation(s) P4 - Poster Session 4 (8:00 AM-9:00 AM)

Poster/Presentation
Number 1-001

Objective

To assess the efficacy and safety of inebilizumab as a salvage therapy for acute NMOSD-ON when corticosteroids fail, and explore its potential as a first-line treatment.

Background Acute attacks of NMOSD-ON frequently result in severe, irreversible optic nerve damage and visual loss. Current first-line acute-phase therapies, such as intravenous methylprednisolone (IVMP), often result in suboptimal responses in a significant proportion of patients, thus highlighting the need for more effective acute-phase salvage therapies. While inebilizumab effectively prevents NMOSD relapses, its role in acute NMOSD-ON attacks remains unexplored.

Design/Methods

This single-center, open-label, retrospective, case-control study included 8 patients with AQP4(+) NMOSD-ON in the acute phase. The inebilizumab group (n=4) received 300 mg of inebilizumab intravenously immediately after ineffective corticosteroid, with a repeat dose on day 15. The control group (n=4) did not receive inebilizumab or other salvage therapies but initiated inebilizumab 3 months post-attack. The primary outcomes were best-corrected visual acuity (BCVA), visual field, and peripapillary retinal nerve fiber layer (pRNFL) thickness. Secondary outcomes included safety and relapse status. The patients were followed up for 6 months.

Results The inebilizumab group exhibited superior improvement in visual field mean deviation (VF-MD) compared to the control group (8.72±10.18 vs 6.66±5.463, p<0.05). Thinning of the pRNFL (-3.67±12.896 vs -4.00±13) and ganglion cell layer (GCL) (0.67±1.528 vs 10.00±22.60) was less pronounced in the inebilizumab group. LogMAR visual acuity improved more significantly in the inebilizumab group (-1.03±1.18 vs -0.93±0.67, p<0.05). In the inebilizumab group, two patients experienced transient fatigue and weakness post-treatment, and one developed shingles at the 6-month follow-up, which resolved with antiviral therapy. No other adverse events or relapses were observed.

Conclusions Inebilizumab salvage therapy appears to be effective and well-tolerated in acute NMOSD-ON. Large-scale prospective randomized controlled trials are warranted to further validate these findings.

Authors/Disclosures
Hui Yang PRESENTER	The institution of Dr. Yang has received research support from Guangdong Provincial Natural Science Foundation.
yaping Cao	Ms. Cao has nothing to disclose.
Lin Xu, MS	Ms. Xu has nothing to disclose.

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