Treatment of neuromyelitis optica: Review and recommendations

Dorlan J. Kimbrough, Kazuo Fujihara, Anu Jacob, Marco A. Lana-Peixoto, Maria Isabel Leite, Michael Levy, Romain Marignier, Ichiro Nakashima, Jacqueline Palace, Jrme De Seze, Olaf Stuve, Silvia N. Tenembaum, Anthony Traboulsee, Emmanuelle Waubant, Brian G. Weinshenker, Dean M. Wingerchuk

Research output: Contribution to journalReview article

143 Scopus citations


Neuromyelitis optica (NMO) is an autoimmune demyelinating disease preferentially targeting the optic nerves and spinal cord. Once regarded as a variant of multiple sclerosis (MS), NMO is now recognized to be a different disease with unique pathology and immunopathogenesis that does not respond to traditional MS immunomodulators such as interferons. Preventive therapy in NMO has focused on a range of immunosuppressive medications, none of which have been validated in a rigorous randomized trial. However, multiple retrospective and a few recent prospective studies have provided evidence for the use of six medications for the prevention of NMO exacerbations: azathioprine, rituximab, mycophenolate mofetil, prednisone, methotrexate and mitoxantrone. This review provides a comprehensive analysis of each of these medications in NMO and concludes with a set of recommended consensus practices.

Original languageEnglish (US)
Pages (from-to)180-187
Number of pages8
JournalMultiple Sclerosis and Related Disorders
Issue number4
StatePublished - Oct 1 2012


  • Aquaporin 4
  • Immunosuppression
  • NMO treatment
  • Neuromyelitis optica
  • Optic neuritis
  • Transverse myelitis

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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  • Cite this

    Kimbrough, D. J., Fujihara, K., Jacob, A., Lana-Peixoto, M. A., Isabel Leite, M., Levy, M., Marignier, R., Nakashima, I., Palace, J., De Seze, J., Stuve, O., Tenembaum, S. N., Traboulsee, A., Waubant, E., Weinshenker, B. G., & Wingerchuk, D. M. (2012). Treatment of neuromyelitis optica: Review and recommendations. Multiple Sclerosis and Related Disorders, 1(4), 180-187.