Case Report: Aquaporin-4-Positive Neuromyelitis Optica Spectrum Disorder: Diagnostic Challenges and Transition From B-Cell Depletion Therapy to Ravulizumab.

This case report illustrates the real-world efficacy of complement component 5 inhibitors in a patient with neuromyelitis optica spectrum disorder who switched from rituximab because of B-cell repopulation occurring early in the course of treatment. Maintenance of remission without relapse was observed when transitioning from rituximab to eculizumab and then to ravulizumab. Results observed in this case support the use of targeted complement inhibition as relapse-preventive therapy after rituximab.