Why carry out this study?

Although current NMOSD treatment guidelines were last updated prior to the approval of several monoclonal antibody drugs, their availability has made decisions around treatment initiation and switch increasingly complex.

This study sought to develop a clearer understanding of patient characteristics and other drivers behind treatment initiation, treatment choice, and switch in clinical practice through a global clinical record review and patient interviews.

What was learned from the study?

Misdiagnosis of NMOSD is common (25% [228/910] of patients from the clinical record review were initially misdiagnosed) and was a factor associated with treatment delay and more frequent relapses (mean 3.3 vs 2.8) compared with correct diagnosis.

Oral corticosteroids/immunosuppressive therapies were typically the first-line maintenance therapy of choice for the majority of neurologists, and relapse severity was a key factor in treatment decisions, including use of monoclonal antibodies.

This research provides insights into real-world factors driving treatment decisions in this rare disease and highlights the need for further real-world studies assessing relapse severity as a factor in treatment decisions to guide NMOSD treatment recommendations.