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2020 ; 44
(ä): 102249
Nephropedia Template TP
gab.com Text
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Current and emerging therapeutics for neuromyelitis optica spectrum disorder:
Relevance to the COVID-19 pandemic
#MMPMID32526698
Abboud H
; Zheng C
; Kar I
; Chen CK
; Sau C
; Serra A
Mult Scler Relat Disord
2020[Sep]; 44
(ä): 102249
PMID32526698
show ga
Neuromyelitis optica spectrum disorder (NMOSD) can lead to immobility and bulbar
weakness. This, in addition to the older age of onset and the higher rate of
hospitalization compared to multiple sclerosis, makes this patient group a
potential target for complicated COVID-19 infection. Moreover, many of the
commonly used preventive therapies for NMOSD are cell-depleting
immunouppsressants with increased risk of viral and bacterial infections. The
emergence of several new NMOSD therapeutics, including immune-modulating agents,
concurrently with the worldwide spread of the COVID-19 global pandemic call for
careful therapeutic planning and add to the complexity of NMOSD management.
Altering the common therapeutic approach to NMOSD during the pandemic may be
necessary to balance both efficacy and safety of treatment. Selection of
preventive therapy should take in consideration the viral exposure risk related
to the route and frequency of administration and, most importantly, the
immunological properties of each therapeutic agent and its potential impact on
the risk of SARS-CoV-2 susceptibility and severity of infection. The impact of
the therapeutic agent on the immune response against the future SARS-CoV-2
vaccine should also be considered in the clinical decision-making. In this
review, we will discuss the immune response against SARS-CoV-2 and evaluate the
potential impact of the current and emerging NMOSD therapeutics on infection
risk, infection severity, and future SARS-CoV-2 vaccination. We propose a
therapeutic approach to NMOSD during the COVID-19 pandemic based on analysis of
the mechanism of action, route of administration, and side effect profile of each
therapeutic agent.