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Inebilizumab therapy was determined to be effective for patients with prior exposure to rituximab; however, the majority of these patients experienced infections, increasing the need for vigilance.

Neuromyelitis optica spectrum disorder (NMOSD) is a chronic and rare autoimmune inflammatory disorder affecting the central nervous system (CNS). NMOSD is characterized by repeated attacks of transverse myelitis, optic neuritis, and brain involvement. Inebilizumab is effective for NMOSD patients who have been treated previously with rituximab, according to a study published in Multiple Sclerosis and Related Disorders. Study findings suggest that the efficacy of inebilizumab, an anti-CD19 B-cell-depleting antibody, could potentially serve as an effective therapeutic option for individuals with NMOSD, regardless of their prior exposure to rituximab.

Annualized Attack Rates Were Similar Among Participants

The annualized attack rates (AAR) of study participants previously treated with rituximab was reduced to 0.08, similar to the AAR of 0.10 in participants without previous exposure to rituximab. This indicates that inebilizumab is potentially effective in patients for whom rituximab treatment has failed.

The Safety Profile of Inebilizumab Was Similar Among Participants

According to the study findings, 94% of the participants who had received prior rituximab treatment reported experiencing infection, which is notably higher than the rate of infection in participants who had not undergone prior treatment (70%). The safety profile of the two groups was similar, characterized by similar infusion-related reactions and treatment-emergent adverse events (TEAEs).

Lower IgG Levels in Patients Previously Treated With Rituximab

The study revealed that the majority of the infections reported by the participants were categorized as grade 1/2. Additionally, a greater proportion of the patients who had received prior rituximab treatment exhibited IgG levels below 500 mg/dL, compared to the participants who had not undergone rituximab treatment.

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This analysis supports the clinical effectiveness of inebilizumab in the prevention of attacks in NMOSD patients with prior treatment experience with rituximab. Future studies should investigate the potential safety concerns, including hypogammaglobulinemia and infection risk in NMOSD patients previously treated with rituximab.


Flanagan, E. P., Levy, M., Katz, E., Cimbora, D., Drappa, J., Mealy, M. A., She, D., & Cree, B. A. C. (2022). Inebilizumab for treatment of neuromyelitis optica spectrum disorder in patients with prior rituximab use from the N-MOmentum Study. Mult Scler Relat Disord, 57, 103352. https://doi.org/10.1016/j.msard.2021.103352