Highlights
- •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
Abstract
Background
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.
Methods
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.
Results
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.
Conclusions
The recommendations of these consensus guidelines seek to optimize management and
specific treatment of NMOSD patients in LATAM
Keywords
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Article info
Publication history
Published online: July 28, 2020
Accepted:
July 27,
2020
Received in revised form:
July 24,
2020
Received:
April 25,
2020
Identification
Copyright
© 2020 Elsevier B.V. All rights reserved.
