Inebilizumab’s Impact on B-Cells, Plasmablasts, and Plasma Cells in NMOSD: Bruce Cree, MD, PhD, MAS, FAAN


The clinical research director of the UCSF Multiple Sclerosis Center provided insight on an abstract from ECTRIMS 2022 regarding inebilizumab’s mechanism of action to prevent NMOSD attacks. [WATCH TIME: 3 minutes]

WATCH TIME: 3 minutes

"As long as you’re thinking ahead and planning to include acquisition of biologically relevant material, you might find something interesting about the disease state itself."

In June 2020, the FDA approved inebilizumab (Uplizna; Horizon) for the treatment of Neuromyelitis optica spectrum disorder (NMOSD), becoming only the second therapy approved for the autoimmune disease. The approval was based on the phase 3 N-MOmentum study (NCT02200770), which originally showed a reduction in risk of NMOSD relapse by 77% in those on inebilizumab relative to placebo. Since its approval, there have been several new post-hoc analyses from the trial, including one presented at the recently concluded 2022 European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) Congress, October 26-28, in Amsterdam, Netherlands.

Led by Bruce Cree, MD, PhD, MAS, FAAN, the analysis aimed to clarify the relationship between peripheral B-cell subsets in the blood, aquaporin-4 immunoglobulin (AQP4-IgG) levels, and NMOSD attacks. All told, treatment with inebilizumab resulted in significantly decreased AQP4-IgG+ titer relative to placebo. Specifically, at the end of the randomized control period, 37% (59 of 159) of participants treated with the agent had at least a 2-fold decrease in AQP4-IgG titers from baseline compared with 18% (9 of 50) of those on placebo (P = .01). The difference in number of patients with at least a 2-fold decrease in these titers was even greater among those with high titers at baseline.1

Cree, the clinical research director of the UCSF Multiple Sclersosis Center, caught up with NeurologyLive® at ECTRIMS 2022 to discuss the analysis, and how the clinical community should perceive the findings. Additionally, he provided context on the benefit these types of analyses bring to the NMOSD community.

Click here for more coverage of ECTRIMS 2022.

1. New analysis of Uplizna (Inebilizumab-cdon) phase 3 trial data demonstrates importance of reducing plasmablasts to help prevent neuromyelitis optica spectrum disorder (NMOSD) attacks. News release. Horizon. October 26, 2022. Accessed November 1, 2022.
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