B-Cell Targeted Treatments for Neuromyelitis Optica Spectrum Disorder: A Focus on CD19 and CD20

Abstract

Neuromyelitis optica spectrum disorder (NMOSD) is a rare relapsing autoimmune disease of the central nervous system that preferentially targets the optic nerves and spinal cord, leading to visual loss and impaired mobility. Until 2019, no medications were FDA-approved for NMOSD treatment, and standard of care was based on mostly empiric and retrospective data. Therapies that target B cells emerged as a treatment strategy due to their fundamental role in disease pathogenesis. We explore different monoclonal antibodies directed at either CD20+ or CD19+ B cells that may have utilization in the treatment of NMOSD, discussing what is known regarding their efficacy and safety.

Keywords:

• rituximab
• inebilizumab
• NMO
• MOG
• monoclonal

Disclosure

Michael Levy has received consulting income from Horizon Therapeutics (manufacturer of inebilizumab), Genentech (manufacturer of rituximab), Alexion, UCB Pharmaceuticals and Mitsubishi Pharmaceuticals. He has also received grants from these companies funding research at Massachusetts General Hospital. Maureen A. Mealy works for Horizon Therapeutics, the manufacturer of inebilizumab. Her contribution to the manuscript herein does not necessarily represent the views of Horizon Therapeutics. The authors report no other potential conflicts of interest for this work.