Comparison of inebilizumab or rituximab in addition to glucocorticoid therapy for neuromyelitis optica spectrum disorders.

Aim: To investigate the short-term efficacy and safety of inebilizumab for neuromyelitis optica spectrum disorders (NMOSD).

Methods: A total of 33 patients with NMOSD treated with inebilizumab (Group INB, =15) or rituximab (Group RTX, =18) in addition to high-dose glucocorticoids were included. Both groups underwent hormone shock therapy during the acute phase. Subsequently, Group INB received inebilizumab injections during the remission phase, while Group RTX received rituximab injections. A comparison of aquaporins 4 (AQP4) titer values, peripheral blood B lymphocyte counts, and visual function recovery was conducted before and 8wk after treatment. Additionally, adverse reactions and patient tolerability were analyzed after using inebilizumab treatment regimes.

Results: Following inebilizumab treatment, there was a significantly improvement in the visual acuity of NMOSD patients (<0.05), accompanied by a notable decrease in AQP4 titer values and B lymphocyte ratio (<0.05). Moreover, inebilizumab treatment showed a partial effect in preventing optic nerve atrophy (<0.05). However, there were no significant differences in other therapeutic effects compared to rituximab, which has previously demonstrated substantial therapeutic efficacy (>0.05). Furthermore, inebilizumab exhibited higher safety levels than that of rituximab injections.

Conclusion: The combination of inebilizumab and high-dose glucocorticoids proves to be effective. In comparison to rituximab injections, inebilizumab displays better tolerance and safety. Moreover, it demonstrates a partial effect in preventing optic nerve atrophy. Thus, it stands as an effective method to reduce the disability rates and improve the daily living ability of patients with NMOSD.