Neuroimmunological Diseases by Susumu Kusunoki

Author:Susumu Kusunoki
Language: eng
Format: epub
Publisher: Springer Japan, Tokyo

8.2.1.4 Patients Resistant to IVMP and Plasmapheresis

Although the efficacy of novel therapeutic drugs including monoclonal antibodies is now being investigated, drugs currently used for other autoimmune diseases have also been applied for the treatment of acute attacks in patients with NMO resistant to steroid and PE therapies.

Since IVIG has comparable effects as PE in other autoimmune diseases such as Guillain-Barré syndrome, a case series demonstrated that patients with myelitis who respond unsuccessfully to steroid therapy showed significant improvement after IVIG therapy [43].

Interestingly, there is a case report indicating that patients refractory to both IVMP and PE responded successfully to cyclophosphamide infusion [44]. The efficacy of cyclophosphamide for patients with idiopathic transverse myelitis has also been previously reported [45].

Whether these novel approaches can be beneficial to other patients with NMO and NMOSD in general awaits future investigations.

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