Update on diagnosis and treatment of neuromyelitis optica spectrum disorders (NMOSD) — recommendations of Section of Multiple Sclerosis and Neuroimmunology of Polish Neurological Society

Abstract

Introduction. An expert panel of the Section of Multiple Sclerosis and Neuroimmunology of the Polish Neurological Society has developed principles for the management of neuromyelitis optica spectrum disorders (NMOSD). These principles are based on expert opinion and data from the literature published up to May 2023. Recommendations were developed based on the results of the most recent clinical trials, guidelines of foreign and international scientific societies, and the authors’ clinical experience. Clinical implications. The principles for diagnosing NMOSD are discussed, with particular emphasis on serological and neuro-imaging diagnosis. Recommendations for the treatment of relapses and chronic immunosuppressive treatment, including the most recent methods of immunotherapy, are also presented. Additionally, the principles of monitoring treatment efficacy and safety are included. Therapy regimens are completed with recommendations for symptomatic treatment. The paper also includes an algorithm for vaccination in patients with NMOSD. Therapeutic management in pregnant women with NMOSD is discussed.