AUTHOR=Lehrieder Dominik , Zapantis Nikolaos , Pham Mirko , Schuhmann Michael Klaus , Haarmann Axel TITLE=Treating seronegative neuromyelitis optica spectrum disorder with inebilizumab: a case report JOURNAL=Frontiers in Neurology VOLUME=14 YEAR=2023 URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1297341 DOI=10.3389/fneur.2023.1297341 ISSN=1664-2295 ABSTRACT=Background

Neuromyelitis optica spectrum disorder (NMOSD) is a devastating inflammatory disease of the central nervous system that is often severely disabling from the outset. The lack of pathognomonic aquaporin 4 (AQP4) antibodies in seronegative NMOSD not only hinders early diagnosis, but also limits therapeutic options, in contrast to AQP4 antibody-positive NMOSD, where the therapeutic landscape has recently evolved massively.

Case presentation

We report a 56-year-old woman with bilateral optic neuritis and longitudinally extensive myelitis as the index events of a seronegative NMOSD, who was successfully treated with inebilizumab.

Conclusion

Treatment with inebilizumab may be considered in aggressive seronegative NMOSD. Whether broader CD19-directed B cell depletion is more effective than treatment with rituximab remains elusive.