Tratamento da neuromielite óptica: Uma revisão baseada em evidências

Translated title of the contribution: Treatment of neuromyelitis optica: An evidence based review

Douglas Sato, Dagoberto Callegaro, Marco Aurélio Lana-Peixoto, Kazuo Fujihara

Research output: Contribution to journalArticlepeer-review

39 Citations (Scopus)

Abstract

Neuromyelitis optica (NMO) is an inflammatory disease of the central nervous system characterized by severe optic neuritis and transverse myelitis, usually with a relapsing course. Aquaporin-4 antibody is positive in a high percentage of NMO patients and it is directed against this water channel richly expressed on foot processes of astrocytes. Due to the severity of NMO attacks and the high risk for disability, treatment should be instituted as soon as the diagnosis is confirmed. There is increasing evidence that NMO patients respond differently from patients with multiple sclerosis (MS), and, therefore, treatments for MS may not be suitable for NMO. Acute NMO attacks usually are treated with high dose intravenous corticosteroid pulse and plasmapheresis. Maintenance therapy is also required to avoid further attacks and it is based on low-dose oral corticosteroids and non-specific immunosuppressant drugs, like azathioprine and mycophenolate mofetil. New therapy strategies using monoclonal antibodies like rituximab have been tested in NMO, with positive results in open label studies. However, there is no controlled randomized trial to confirm the safety and efficacy for the drugs currently used in NMO.

Translated title of the contributionTreatment of neuromyelitis optica: An evidence based review
Original languagePortuguese
Pages (from-to)59-66
Number of pages8
JournalArquivos de Neuro-Psiquiatria
Volume70
Issue number1
DOIs
Publication statusPublished - 2012 Jan

Keywords

  • Aquaporin 4
  • Azathioprine
  • Cyclophosphamide
  • Interferon-beta
  • Mitoxantrone
  • Monoclonal antibodies
  • Mycophenolic acid
  • Neuromyelitis optica
  • Plasmapheresis
  • Steroids
  • Therapy

ASJC Scopus subject areas

  • Clinical Neurology
  • Biological Psychiatry

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