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ACTRIMS 2022 | Chronic cognitive impairment improved after eculizumab initiation in cases of NMOSD

Dalia Rotstein, MD, MPH, St. Michael’s Hospital and the University of Toronto, Toronto, ON, details cases of AQP4+ neuromyelitis optica spectrum disorder (NMOSD) where substantial cognitive improvement was seen after eculizumab initiation. Eculizumab became the first FDA approved treatment for AQP4+ NMOSD in 2019 and is known to significantly reduce relapse risk compared to placebo. In two recent cases, patients with AQP4+ NMOSD presenting with cognitive decline over more than 6 months, eculizumab therapy was shown to partially reverse chronic cognitive impairment. Extensive callosal involvement and an element of ongoing gadolinium enhancement on MRI were features common to both cases. The findings bring into question whether cognition may be a valuable, treatable target in NMOSD, and necessitates further investigation in a dedicated cognition study. This interview took place at the ACTRIMS Forum 2022 in West Palm Beach, Florida.

Disclosures

Dr Dalia Rotstein has received research support from the MS Society of Canada, CMSC and Roche. She has received speaker or consultant fees from Alexion, Biogen, EMD Serono, Novartis, Roche and Sanofi Aventis.