EFFICACY AND SAFETY OF INEBILIZUMAB USE IN NEUROMYELITIS OPTICA SPECTRUM DISORDER (NMOSD): A SYSTEMATIC REVIEW OF THE LITERATURE EVIDENCE

Abstract

This article sought to evaluate the efficacy and safety of inebilizumab in adults with neuromyelitis optica spectrum disorder (NMOSD), compared with placebo or other immunosuppressive and biological therapies. It is a systematic review conducted according to the PRISMA 2020 guidelines, with searches in PubMed and Periódicos CAPES and study selection by two independent reviewers, resulting in the inclusion of 11 articles, one of which was a randomized clinical trial and the rest observational studies. The N-Momentum trial showed relapses in 12% of patients treated with inebilizumab versus 39% in the placebo group, and real-world studies reported lower relapse rates than with rituximab, azathioprine, and mycophenolate mofetil, although not all differences were significant. Regarding safety, adverse events occurred at a frequency similar to placebo, but hypogammaglobulinemia, mainly due to reduced IgG, and infections were described. It is concluded that inebilizumab is an effective option for preventing NMOSD relapses, especially in AQP4-IgG-positive patients, although the predominance of observational studies and short follow-up preclude claims of superiority over other therapies.