Abstract Details

Title Clinical Practice Experience With Satralizumab in NMOSD: Impact on Pain, Polypharmacy, and Glucocorticoid Reduction

Topic Multiple Sclerosis

Presentation(s) P6 - Poster Session 6 (5:00 PM-6:00 PM)

Poster/Presentation
Number 20-012

Objective

To evaluate changes in pain severity, number and types of concomitant medications, and glucocorticoid (GC) tapering following satralizumab treatment in patients with neuromyelitis optica spectrum disorder (NMOSD) in routine clinical practice.

Background NMOSD is a relapsing autoimmune disorder of the central nervous system, often accompanied by neuropathic pain due to spinal cord lesions. Long-term GC and immunosuppressant therapy often results in polypharmacy. Satralizumab, an interleukin-6 (IL-6) receptor inhibitor, effectively prevents relapses in NMOSD; however, its real-world effects on pain management and polypharmacy remain to be fully elucidated.

Design/Methods We retrospectively analyzed 23 patients (21 women, 91%) with AQP4-IgG–positive NMOSD treated at a single center between 2014 and 2025. Satralizumab (120 mg) was administered subcutaneously at weeks 0, 2, and 4, then every 4 weeks. Pre- and post-initiation comparisons included numerical rating scale (NRS) pain scores (0–10), numbers and types of concomitant medications, and daily GC dose.

Results The mean age at initiation was 54 years, with a median follow-up of 2.3 years. One patient experienced a relapse. At baseline, 86% reported pain; among those continuing treatment, the median NRS improved from 7 to 4 (p < 0.001), and over 50% reported subjective pain relief. The mean daily prednisolone dose decreased from 10 mg to 4 mg (p < 0.001), with most patients tapering GCs without relapse. The mean number of medications decreased from 12 to 10 (p < 0.05); 59% initially used ≥10 drugs. At initiation, 96% were receiving oral prednisolone; other frequently used drugs included antacids (96%), osteoporosis agents (86%), and analgesics (65%).

Conclusions In routine clinical practice, satralizumab is associated with improved pain, reduced medication use, and successful GC tapering while maintaining relapse control. These findings suggest that IL-6 receptor inhibition may not only prevent relapses but also mitigate polypharmacy and improve quality of life in patients with NMOSD.

Authors/Disclosures
Ryotaro Ikeguchi PRESENTER	Ryotaro Ikeguchi has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Chugai Pharmaceutical Co., Ltd.. Ryotaro Ikeguchi has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis Pharma K.K.. Ryotaro Ikeguchi has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Mitsubishi Tanabe Pharma Corporation. Ryotaro Ikeguchi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for argenx Japan K.K.. Ryotaro Ikeguchi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alexion Pharma GK. Ryotaro Ikeguchi has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Chugai Pharmaceutical Co., Ltd.. Ryotaro Ikeguchi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Mitsubishi Tanabe Pharma Corporation. Ryotaro Ikeguchi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for UCB Japan Co., Ltd.. Ryotaro Ikeguchi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis Pharma K.K.. Ryotaro Ikeguchi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen Japan Ltd..
Yuko Shimizu, MD, PhD (Tokyo Women'S Medical University School of Medicine)	Dr. Shimizu has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Biogen Japan.. Dr. Shimizu has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Novartis Pharma. Dr. Shimizu has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Chigai Pharma CoLtd.
Rie Kuroda, MD	No disclosure on file
Kenichi Todo, MD, PhD	Prof. Todo has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Daiichi Sankyo. Prof. Todo has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for FP Pharmaceutical Corporation. Prof. Todo has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Eisai. Prof. Todo has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Abbott Medical Japan. Prof. Todo has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Kowa. Prof. Todo has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Otsuka Pharmaceutical. Prof. Todo has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Chugai Pharmaceutical.

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