Multiple sclerosis and related disorders · 2025
Satralizumab treatment in neuromyelitis optica spectrum disorder: effects on relapse, pain, and other medications used: a retrospective chart review.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Ikeguchi Ryotaro, Shimizu Yuko, Kuroda Rie, Todo Kenichi
Аннотация
BACKGROUND: Glucocorticoids and immunosuppressants are used for neuromyelitis optica spectrum disorder (NMOSD) relapse suppression. Recently, biologics have demonstrated efficacy in relapse prevention. We aimed to evaluate the effects of satralizumab, an interleukin-6 receptor inhibitor, on relapse prevention, pain management, glucocorticoid tapering, and number of medications.
METHODS: This single-center observational study retrospectively analyzed 23 patients (21 women) with AQP4-IgG-seropositive NMOSD treated with satralizumab. Satralizumab was administered subcutaneously at 120 mg on weeks 0, 2, and 4 and every 4 weeks thereafter. Clinical parameters, including relapse frequency, severity, pain, medication number, glucocorticoid dosage, and adverse events, were analyzed before and after satralizumab initiation. Pain was assessed using the numerical rating scale (NRS; range 0-10).
RESULTS: The mean age was 41.6 ± 12.3 years at onset and 54.3 ± 11.3 years at satralizumab initiation. The median follow-up duration after initiation was 2.3 years. At initiation, 22 patients (95.6 %) were on oral prednisolone. Relapse occurred in one patient during treatment. Serious infections requiring hospitalization were observed in three patients (urinary tract infections). No deaths occurred. The mean daily prednisolone dose significantly decreased from 9.9 ± 5.7 mg/day (baseline) to 4.1 ± 3.4 mg/day (follow-up). Among 21 patients who continued satralizumab, the average number of medications at initiation was 11.5 ± 6.5, significantly decreasing to 9.6 ± 5.1 at last follow-up. Pain scores improved significantly, with the median NRS score decreasing from 7 to 4.
CONCLUSION: Satralizumab effectively prevented relapses in most patients and was associated with high treatment adherence. Most patients were able to taper glucocorticoids without relapse. Satralizumab appeared beneficial for pain management and polypharmacy reduction. Further studies should explore the mechanisms underlying satralizumab's impact on pain and polypharmacy reduction.
METHODS: This single-center observational study retrospectively analyzed 23 patients (21 women) with AQP4-IgG-seropositive NMOSD treated with satralizumab. Satralizumab was administered subcutaneously at 120 mg on weeks 0, 2, and 4 and every 4 weeks thereafter. Clinical parameters, including relapse frequency, severity, pain, medication number, glucocorticoid dosage, and adverse events, were analyzed before and after satralizumab initiation. Pain was assessed using the numerical rating scale (NRS; range 0-10).
RESULTS: The mean age was 41.6 ± 12.3 years at onset and 54.3 ± 11.3 years at satralizumab initiation. The median follow-up duration after initiation was 2.3 years. At initiation, 22 patients (95.6 %) were on oral prednisolone. Relapse occurred in one patient during treatment. Serious infections requiring hospitalization were observed in three patients (urinary tract infections). No deaths occurred. The mean daily prednisolone dose significantly decreased from 9.9 ± 5.7 mg/day (baseline) to 4.1 ± 3.4 mg/day (follow-up). Among 21 patients who continued satralizumab, the average number of medications at initiation was 11.5 ± 6.5, significantly decreasing to 9.6 ± 5.1 at last follow-up. Pain scores improved significantly, with the median NRS score decreasing from 7 to 4.
CONCLUSION: Satralizumab effectively prevented relapses in most patients and was associated with high treatment adherence. Most patients were able to taper glucocorticoids without relapse. Satralizumab appeared beneficial for pain management and polypharmacy reduction. Further studies should explore the mechanisms underlying satralizumab's impact on pain and polypharmacy reduction.