Inebilizumab-cdon (Uplizna®) could be effective for treating neuromyelitis optica spectrum disorder (NMOSD) without carrying major consequences regarding immune function against coronavirus disease 2019 (COVID-19), according to a news release from Horizon Therapeutics.
“Patients treated with Uplizna appear to not be more susceptible to COVID-19 infections or to develop waning immunity from prior vaccinations due to treatment,” Bruce Cree, MD, PhD, MAS, author of the N-MOmentum study and professor of clinical neurology at the University of California in San Francisco Weill Institute for Neurosciences, said.
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The N-MOmentum clinical trial was a phase 3 study that included 182 patients previously diagnosed with NMOSD who underwent treatment with inebilizumab. This novel drug targets B cells only and depletes them. It was the first medication with this mechanism of action, and it was recently approved by both the US Food and Drug Administration (FDA) and the European Commission (EC) for the treatment of NMOSD.
“Uplizna prevents NMOSD attacks by targeting CD19-expressing B cells that are a key driver of NMOSD activity,” Dr Cree explained.
These results suggest that the effects of inebilizumab are rather selective and could yield the important benefit of modulating the B-cell response, which is greatly involved in the pathophysiology of NMOSD, while still allowing a proper immune response against pathogens.
Moreover, treatment with this drug for 3.5 years did not decrease antibody levels from childhood vaccinations, such as varicella-zoster, measles, mumps, rubella, and tetanus.
Inebilizumab is approved for use in adults with a confirmed diagnosis of NMOSD who test positive for the anti-aquaporin-4 (AQP4) antibody. It is contraindicated in patients with active hepatitis B infection and active or untreated latent tuberculosis. In addition, individuals taking inebilizumab should not receive live or live-attenuated vaccines.
Regardless of these favorable findings, infections remain the most frequent adverse event from this treatment, with urinary tract infections, nasopharyngitis, upper respiratory tract infections, and influenza present in up to 20%, 13%, 8%, and 7% of cases, respectively.
Reference
New data suggest Uplizna® (inebilizumab-cdon) for the treatment of neuromyelitis optica spectrum disorder (NMOSD) did not increase the risk of COVID-19 infection or reduce antibody levels from childhood vaccines. News release. Horizon Therapeutics plc; February 23, 2023.
