Exploring steroid tapering in patients with neuromyelitis optica spectrum disorder treated with satralizumab in SAkuraSky: A case series

Yamamura, Takashi; Araki, Mikiya; Fujihara, Kazuo; Okuno, Tatsusada; Misu, Tatsuro; Guo, Yuh‐Cherng; Hemingway, Cheryl; Matsushima, Junnosuke; Sugaya, Naofumi; Yamashita, Masami; Büdingen, H.-Christian von; Miyamoto, Katsuichi

doi:10.1016/j.msard.2022.103772

Cited by 10 publications

(5 citation statements)

References 21 publications

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“…The rates of AEs and serious AEs with satralizumab treatment in the double-blind and OST periods were similar between the two studies and were comparable with placebo during the double-blind periods, suggesting that satralizumab is well tolerated as an add-on or as monotherapy. Consistent with these findings, a separate analysis of 16 patients who tapered their oral corticosteroid dose during the OLE period of SAkuraSky showed that the satralizumab safety profile in steroidtapered patients was comparable with the overall study population during the doubleblind period (Yamamura, 2022).…”

Section: Discussionsupporting

confidence: 56%

Long-term safety of satralizumab in neuromyelitis optica spectrum disorder (NMOSD) from SAkuraSky and SAkuraStar

Yamamura¹,

Weinshenker²,

Yeaman³

et al. 2022

Multiple Sclerosis and Related Disorders

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Section: Discussionsupporting

confidence: 56%

Long-term safety of satralizumab in neuromyelitis optica spectrum disorder (NMOSD) from SAkuraSky and SAkuraStar

Yamamura¹,

Weinshenker²,

Yeaman³

et al. 2022

Multiple Sclerosis and Related Disorders

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“…Nevertheless, due to a lack of data, it remains a matter of debate when and how to stop background immunosuppressive therapies in patients who stabilize after starting antibody therapy. Data from the OLE of eculizumab showed that 37% of patients were able to stop or decrease their immunosuppressive therapies and remain stable [ 246 ], while data from the OLE of the SAkuraSky trial evaluating satralizumab in combination with immunosuppressive therapies showed that 16 out of 36 patients were able to taper their glucocorticoid dose, 3 stopped it entirely and remained attack-free, while 2 experienced three attacks during tapering [ 249 ]. Interactions between the various treatment modalities need to be considered.…”

Section: Treatment Of Nmosd: General Aspects and Outcome Measuresmentioning

confidence: 99%

Update on the diagnosis and treatment of neuromyelitis optica spectrum disorders (NMOSD) – revised recommendations of the Neuromyelitis Optica Study Group (NEMOS). Part II: Attack therapy and long-term management

Kuempfel¹,

Giglhuber²,

Aktaş³

et al. 2023

J Neurol

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This manuscript presents practical recommendations for managing acute attacks and implementing preventive immunotherapies for neuromyelitis optica spectrum disorders (NMOSD), a rare autoimmune disease that causes severe inflammation in the central nervous system (CNS), primarily affecting the optic nerves, spinal cord, and brainstem. The pillars of NMOSD therapy are attack treatment and attack prevention to minimize the accrual of neurological disability. Aquaporin-4 immunoglobulin G antibodies (AQP4-IgG) are a diagnostic marker of the disease and play a significant role in its pathogenicity. Recent advances in understanding NMOSD have led to the development of new therapies and the completion of randomized controlled trials. Four preventive immunotherapies have now been approved for AQP4-IgG-positive NMOSD in many regions of the world: eculizumab, ravulizumab - most recently-, inebilizumab, and satralizumab. These new drugs may potentially substitute rituximab and classical immunosuppressive therapies, which were as yet the mainstay of treatment for both, AQP4-IgG-positive and -negative NMOSD. Here, the Neuromyelitis Optica Study Group (NEMOS) provides an overview of the current state of knowledge on NMOSD treatments and offers statements and practical recommendations on the therapy management and use of all available immunotherapies for this disease. Unmet needs and AQP4-IgG-negative NMOSD are also discussed. The recommendations were developed using a Delphi-based consensus method among the core author group and at expert discussions at NEMOS meetings.

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“…While PSL serves as a common NMOSD maintenance treatment in select regions, its prolonged use links to severe complications, including infection, moon face, weight gain, gastric ulcers, hypertension, hyperglycemia, cataracts, glaucoma, osteoporosis, and psychosis [ 12 , 13 ]. Significantly, a Japanese study illustrated that PSL doses could be tapered in satralizumab-treated NMOSD patients without escalating annualized relapse rates [ 14 ]. Indeed, in our patient, PSL dosage decreased to 5 mg during pregnancy and further dwindled to 3 mg post-partum.…”

Section: Discussionmentioning

confidence: 99%

Successful Childbirth During Satralizumab Treatment in Neuromyelitis Optica Spectrum Disorder

Nakashima,

Hao,

Uchio

et al. 2024

Cureus

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A 40-year-old woman with neuromyelitis optica spectrum disorder (NMOSD) and anti-aquaporin 4 antibodies suffered three NMOSD episodes between 35 and 37 years of age. Despite treatment with prednisolone and azathioprine, her condition repeatedly relapsed. We introduced satralizumab, targeting interleukin-6 receptors, which stabilized her condition. At the age of 38, she became pregnant and delivered a healthy baby at 38 weeks. Post delivery, both mother and child stayed healthy with no NMOSD relapses. This case illustrates the efficacy and safety of satralizumab in managing NMOSD, especially for women in their reproductive years who are planning pregnancy.

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Exploring steroid tapering in patients with neuromyelitis optica spectrum disorder treated with satralizumab in SAkuraSky: A case series

Cited by 10 publications

References 21 publications

Long-term safety of satralizumab in neuromyelitis optica spectrum disorder (NMOSD) from SAkuraSky and SAkuraStar

Long-term safety of satralizumab in neuromyelitis optica spectrum disorder (NMOSD) from SAkuraSky and SAkuraStar

Update on the diagnosis and treatment of neuromyelitis optica spectrum disorders (NMOSD) – revised recommendations of the Neuromyelitis Optica Study Group (NEMOS). Part II: Attack therapy and long-term management

Successful Childbirth During Satralizumab Treatment in Neuromyelitis Optica Spectrum Disorder

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