Ravulizumab for Aquaporin-4–Positive Neuromyelitis Optica Spectrum Disorder

Neuromyelitis optica is an infrequent autoimmune neuroinflammatory disease of the central nervous system typically characterized by transverse myelitis, optic neuritis, or both that results in accumulation of neurologic disability. Eculizumab, a complement 5 inhibitor, was approved in 2019 for patients with aquaporin-4–positive neuromyelitis optica spectrum disorder (AQP4+ NMOSD). Ravulizumab, another humanized monoclonal antibody complement inhibitor medication approved by the FDA for other conditions, binds to the same C5 epitope as eculizumab but has a longer elimination half-life, which permits a longer dosing interval to every 8 weeks, versus every 2 weeks for eculizumab. In this phase 3, open-label, manufacturer-sponsored trial, inves…