Tocilizumab for Neuromyelitis Optica Spectrum Disorder

Patients with neuromyelitis optica spectrum disorder treated with tocilizumab may experience decreased risks of relapse or disability progression compared to before treatment, but it is uncertain whether these changes can be entirely attributed to tocilizumab (TCZ) treatment. TCZ might be better than azathioprine for patients with neuromyelitis optica spectrum disorder in reducing relapse risk. TCZ might improve or have no impact on pain and fatigue measures for patients with neuromyelitis optica spectrum disorder. Adverse events were common during TCZ treatment, but patients treated with TCZ may experience adverse events at a similar or lower rate to those treated with azathioprine. One evidence-based guideline suggests that TCZ can be used as 1 of the second-line drugs to prevent long-term relapse for patients with neuromyelitis optica spectrum disorder who have no response to other immunosuppressants. We did not find any studies that compared TCZ to other immunosuppressants or any studies on the cost-effectiveness of TCZ for treating neuromyelitis optica spectrum disorder that met the inclusion criteria for this report.