Treatment of neuromyelitis optica: an evidence based review
Autor(a) principal: | |
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Data de Publicação: | 2012 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Arquivos de neuro-psiquiatria (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2012000100012 |
Resumo: | 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. |
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Treatment of neuromyelitis optica: an evidence based reviewneuromyelitis opticatherapyaquaporin 4plasmapheresissteroidsazathioprinemycophenolic acidmonoclonal antibodiesmitoxantronecyclophosphamideinterferon-betaNeuromyelitis 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.Academia Brasileira de Neurologia - ABNEURO2012-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2012000100012Arquivos de Neuro-Psiquiatria v.70 n.1 2012reponame:Arquivos de neuro-psiquiatria (Online)instname:Academia Brasileira de Neurologiainstacron:ABNEURO10.1590/S0004-282X2012000100012info:eu-repo/semantics/openAccessSato,DouglasCallegaro,DagobertoLana-Peixoto,Marco AurélioFujihara,Kazuoeng2012-01-05T00:00:00Zoai:scielo:S0004-282X2012000100012Revistahttp://www.scielo.br/anphttps://old.scielo.br/oai/scielo-oai.php||revista.arquivos@abneuro.org1678-42270004-282Xopendoar:2012-01-05T00:00Arquivos de neuro-psiquiatria (Online) - Academia Brasileira de Neurologiafalse |
dc.title.none.fl_str_mv |
Treatment of neuromyelitis optica: an evidence based review |
title |
Treatment of neuromyelitis optica: an evidence based review |
spellingShingle |
Treatment of neuromyelitis optica: an evidence based review Sato,Douglas neuromyelitis optica therapy aquaporin 4 plasmapheresis steroids azathioprine mycophenolic acid monoclonal antibodies mitoxantrone cyclophosphamide interferon-beta |
title_short |
Treatment of neuromyelitis optica: an evidence based review |
title_full |
Treatment of neuromyelitis optica: an evidence based review |
title_fullStr |
Treatment of neuromyelitis optica: an evidence based review |
title_full_unstemmed |
Treatment of neuromyelitis optica: an evidence based review |
title_sort |
Treatment of neuromyelitis optica: an evidence based review |
author |
Sato,Douglas |
author_facet |
Sato,Douglas Callegaro,Dagoberto Lana-Peixoto,Marco Aurélio Fujihara,Kazuo |
author_role |
author |
author2 |
Callegaro,Dagoberto Lana-Peixoto,Marco Aurélio Fujihara,Kazuo |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Sato,Douglas Callegaro,Dagoberto Lana-Peixoto,Marco Aurélio Fujihara,Kazuo |
dc.subject.por.fl_str_mv |
neuromyelitis optica therapy aquaporin 4 plasmapheresis steroids azathioprine mycophenolic acid monoclonal antibodies mitoxantrone cyclophosphamide interferon-beta |
topic |
neuromyelitis optica therapy aquaporin 4 plasmapheresis steroids azathioprine mycophenolic acid monoclonal antibodies mitoxantrone cyclophosphamide interferon-beta |
description |
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. |
publishDate |
2012 |
dc.date.none.fl_str_mv |
2012-01-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2012000100012 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2012000100012 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/S0004-282X2012000100012 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Academia Brasileira de Neurologia - ABNEURO |
publisher.none.fl_str_mv |
Academia Brasileira de Neurologia - ABNEURO |
dc.source.none.fl_str_mv |
Arquivos de Neuro-Psiquiatria v.70 n.1 2012 reponame:Arquivos de neuro-psiquiatria (Online) instname:Academia Brasileira de Neurologia instacron:ABNEURO |
instname_str |
Academia Brasileira de Neurologia |
instacron_str |
ABNEURO |
institution |
ABNEURO |
reponame_str |
Arquivos de neuro-psiquiatria (Online) |
collection |
Arquivos de neuro-psiquiatria (Online) |
repository.name.fl_str_mv |
Arquivos de neuro-psiquiatria (Online) - Academia Brasileira de Neurologia |
repository.mail.fl_str_mv |
||revista.arquivos@abneuro.org |
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