Satralizumab treatment in adults with aquaporin-4 immunoglobulin G-seropositive neuromyelitis optica spectrum disorder in clinical practice. Mult Scler J Exp Transl Clin 2025;11(4):20552173251386895
Date
12/12/2025Pubmed ID
41383264Pubmed Central ID
PMC12690068DOI
10.1177/20552173251386895Scopus ID
2-s2.0-105024815158 (requires institutional sign-in at Scopus site) 1 CitationAbstract
BACKGROUND: Satralizumab is approved for aquaporin-4 immunoglobulin G-positive (AQP4-IgG+) neuromyelitis optica spectrum disorder (NMOSD), but real-world data are limited. This case series aimed to describe real-world experiences with satralizumab in adults with AQP4-IgG+ NMOSD.
METHODS: Case information for patients with AQP4-IgG+ NMOSD who received satralizumab for ≥6 months was obtained from US healthcare providers over 28 months. Patient characteristics, examination findings, diagnostic tests, treatment responses, and adverse events were recorded.
RESULTS: Of 43 patients, 88% were female and 44% self-identified as Black. Median age was 54 (range, 20-82) years, and time since confirmed NMOSD diagnosis was 8 (1-18) years. Reasons for satralizumab initiation included intolerance/safety concerns with existing therapy (30%), new diagnosis (26%), and inadequate disease control (21%). The median duration of satralizumab treatment was 31 (range, 7-104) months, during which three patients (7%) had radiographically confirmed relapses and 15 (35%) experienced a related adverse event. At data cutoff, 35 patients (81%) were receiving satralizumab.
CONCLUSION: Satralizumab was effective and well tolerated in patients with NMOSD, including those who switched from previous treatments due to inadequate disease control and/or intolerance. These real-world outcomes align with long-term safety and efficacy findings from the Phase III SAkura trials.
