Early anti-C5 therapy in NMOSD: rationale and clinical evidence - PubMed
5 hours ago
- #Complement inhibition
- #NMOSD
- #Ravulizumab
- Complement-mediated astrocyte injury is central to AQP4-IgG+ NMOSD.
- C5 inhibitors like ravulizumab are approved for relapse prevention but their role in acute attacks is unclear.
- A 39-year-old woman with severe AQP4-IgG+ NMOSD showed no improvement with standard therapies but responded to ravulizumab.
- After ravulizumab treatment, CH50 became undetectable, indicating effective complement inhibition, and the patient showed significant recovery.
- EDSS improved from 9.0 to ~1.5-2.0 over a year, with normalized CSF parameters and no relapses.
- The case supports early ravulizumab use in severe refractory NMOSD, but further studies are needed for optimal timing and patient selection.