Achieving Consensus and Expanding Treatment Horizons in NMOSD: Lorna Galleguillos, MD; Ricardo Alonso MD, MSc


The neuroimmunologist at Clínica Alemana de Santiago and the head of the University Center for Multiple Sclerosis at Ramos Mejía Hospital talked about Latin America’s pursuit of expanding treatment options and patient inclusivity as a focus of neurological censuses in NMOSD. [WATCH TIME: 5 minutes]

WATCH TIME: 5 minutes

“Our region is big with different realities; we have different access to the treatment in different health care systems. We need to keep in mind that there are a lot of differences among these countries, and we need a consensus in our region. A couple of years ago, we didn't have any approved medications for NMOSD and now we have them, but they are only for patients who are AQP4+. Our focus now is to separate with and without AQP4+ and give the consensus to the neurological community about the treatment.”

In the last couple of decades, the field of neuromyelitis optica spectrum disorder (NMOSD) has experienced significant advancements including new diagnostic markers and criteria as well as better recognition of clinical phenotypes, better disease prognosis and new approved therapies. Despite this progress, clinician who have patients with NMOSD in Latin America (LATAM) have been going through some challenges in helping their patients manage the complex disease because of an unachieved consensus.

In a recent review, researchers investigated how the disease should be managed and treated among LATAM patients to improve long-term outcomes in these populations.1 A panel of LATAM experts in demyelinating diseases and NMOSD gathered virtually during 2019 and 2020 to make consensus recommendations on management and treatment of patients in LATAM using the RAND/UCLA methodology. The experts recommended focusing on diagnosis and differential diagnoses, disease prognosis, and tailored treatment, ultimately recommending and focusing on the identification of suboptimal treatment response and special circumstances management, according to published evidence and other expert opinions.

Recently at MSMilan 2023, the 9th Joint ECTRIMS-ACTRIMS meeting, held October 11-13, in Milan, Italy, Lorna Galleguillos, MD, a neuroimmunologist at Clínica Alemana de Santiago, in Vitacura, Chile, and Ricardo Alonso MD, MSc, the head of the University Center for Multiple Sclerosis, Ramos Mejía Hospital, in Buenos Aires, Argentina, sat down with NeurologyLive® at the meeting to discuss how the RAND/UCLA methodology facilitates the consensus-building process among neurologists. The duo talked about the key challenges faced in Latin America when it comes to accessing FDA-approved medications for neurological conditions. In addition, they spoke about how the inclusion of double-negative NMOSD patients broadens the scope of treatment options, and the challenges this expansion poses in Latin America.

Click here for more coverage of MSMilan 2023.

1. Carnero Contentti E, Rojas JI, Cristiano E, et al. Latin American consensus recommendations for management and treatment of neuromyelitis optica spectrum disorders in clinical practice. Mult Scler Relat Disord. 2020;45:102428. doi:10.1016/j.msard.2020.102428
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