Latin American consensus recommendations for management and treatment of neuromyelitis optica spectrum disorders in clinical practice

• Published in: Multiple sclerosis and related disorders 2020-10, Vol.45, p.102428-102428, Article 102428
• Main Authors: Carnero Contentti, Edgar, Rojas, Juan Ignacio, Cristiano, Edgardo, Marques, Vanessa Daccach, Flores-Rivera, José, Lana-Peixoto, Marco, Navas, Carlos, Papais-Alvarenga, Regina, Sato, Douglas K., Soto de Castillo, Ibis, Correale, Jorge
• Format: Article
• Language: English
• Subjects: Antibody testing; Clinical practice; Consensus; Consensus recommendations; Diagnosis; Humans; Latin America; Neurologists; Neuromyelitis Optica - diagnosis; Neuromyelitis Optica - therapy; Neuromyelitis optica spectrum disorder; Prognosis
• ISSN: 2211-0348; 2211-0356
• DOI: 10.1016/j.msard.2020.102428

•The 2015 NMOSD and 2018 MOG-ab diagnostic criteria must be used in LATAM patients.•The panel recommends to test AQP4-ab and MOG-ab using cell-based assay•A standardized MRI protocol should be applied at diagnosis and follow-up.•For exacerbations, early IV steroids or PLEX (no response to steroids) must be used•We recommend rituximab or mycophenolate use for long-term relapse prevention During the last two decades, neuromyelitis optica spectrum disorder (NMOSD) has undergone important changes, with new diagnostic markers and criteria, better recognition of clinical phenotypes, better disease prognosis and new therapeutic approaches. Consequently, management of NMOSD patients in Latin American (LATAM) has become more complex and challenging in clinical practice. In making these consensus recommendations, the aim was to review how the disease should be managed and treated among LATAM patients, in order to improve long-term outcomes in these populations. A panel of LATAM neurologists who are experts in demyelinating diseases and dedicated to management and care of NMOSD patients gathered virtually during 2019 and 2020 to make consensus recommendations on management and treatment of NMOSD patients in LATAM. To achieve this consensus, the RAND/UCLA methodology for reaching formal consensus was used. The recommendations focused on diagnosis and differential diagnoses, disease prognosis, tailored treatment, identification of suboptimal treatment response and special circumstances management. They were based on published evidence and expert opinions. The recommendations of these consensus guidelines seek to optimize management and specific treatment of NMOSD patients in LATAM