ArticleAnnals of Indian Academy of Neurology2025
Efficacy and Safety of Telitacicept and Mycophenolate Mofetil in the Treatment of Neuromyelitis Optica Spectrum Disorders.
Article in Annals of Indian Academy of Neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
BACKGROUND AND
objectivesTo compare the efficacy and safety of telitacicept versus mycophenolate mofetil (MMF) in reducing relapses and disability in adults with neuromyelitis optica spectrum disorder (NMOSD).
methodsIn this retrospective cohort study, we analyzed 41 adults with NMOSD (2015 diagnostic criteria). Patients received ≥6 months of telitacicept or MMF treatment. Primary outcomes were annualized relapse rate (ARR) and relapse-free survival; secondary outcomes included Expanded Disability Status Scale (EDSS) score, CD19 + B-cell count, and safety.
resultsOver a median follow-up of 8 months for telitacicept (n = 15) and 9 months for MMF (n = 26), patients receiving telitacicept exhibited an 86.7% relapse-free rate (13/15) versus 57.6% (15/26) with MMF, with a significantly prolonged time to first relapse (hazard ratio 0.22, 95% confidence interval: 0.05-0.91; P = 0.04). The magnitude of ARR reduction was significantly greater with telitacicept (median ΔARR 2.0 [interquartile range (IQR) 2.0-4.0]) than with MMF (2.0 [1.0-2.0]; P = 0.007). Neurological function improved markedly, evidenced by a 2.5-point reduction (IQR: 2.0-3.0) in EDSS scores with telitacicept versus 0.5 points (IQR: 0.5-1.0) for MMF ( P < 0.001). Mechanistically, telitacicept induced deeper CD19 + B-cell suppression (Δ51.0 cells/μL [42.0-70.0]) than MMF (Δ28.5 cells/μL [8.0-40.2]; P = 0.002). Safety profiles favored telitacicept, with adverse events occurring in 20.0% (3/15) versus 42.3% (11/26) in the MMF group, though no severe events were observed in either cohort.
conclusionBoth telitacicept and MMF demonstrated favorable clinical efficacy and safety in NMOSD treatment. Compared with MMF, telitacicept exhibits potential advantages and holds promising prospects for clinical application.
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