My sister has NMOSD. Are there new therapies for her age?

Question

Hello doctor,

My sister is 34 and was diagnosed with NMOSD after repeated vision loss and weakness in her legs. Her blood test came positive for AQP4 antibodies.

She is now on steroids, but relapses keep happening. We had never heard of this disease before. So please give your opinions on:

Is it like multiple sclerosis?
Will it cause permanent disability?
Are there newer treatments available for women of her age?

Kindly suggest.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Neuromyelitis optica spectrum disorder (NMOSD) is different from multiple sclerosis, though both can look similar initially. In NMOSD, the immune system primarily targets the optic nerves and spinal cord, often resulting in severe relapses.

AQP4 (aquaporin-4) antibody positivity confirms the diagnosis. Unfortunately, each relapse can leave behind permanent damage, so vision loss or weakness may become irreversible over time if not well-controlled.

Unlike MS (multiple sclerosis), NMOSD rarely has slow progression between attacks but causes step-wise disability from relapses.

Long-term steroids are not ideal because of side effects, so newer targeted therapies are preferred.

Immunosuppressants like Azathioprine or Mycophenolate can reduce relapses, and newer biologics such as Eculizumab, Inebilizumab, or Satralizumab are now available specifically for NMOSD with proven efficacy.

These treatments are safe for women of her age, but they require regular monitoring and sometimes vaccination beforehand. Early and sustained treatment is very important to preserve vision, mobility, and quality of life.

Regular neurologist follow-up and relapse prevention are the keys to avoiding long-term disability.

I hope this helps.

Thank you.