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Bortezomib for Neuromyelitis Optica Spectrum Disorder – A Reply Letter

Bortezomib for Neuromyelitis Optica Spectrum Disorder

A New Therapeutic Option for the More Severe Forms? A Reply Letter

To the Editor – We read with interest the article by Zhang et al1 that described 5 patients with treatment-resistant aquaporin-4 antibody (AQP4-Ab)–positive neuromyelitis optica spectrum disorders (NMOSD) who were administered the proteasome inhibitor bortezomib. This observational study showed a marked reduction in relapse rates and AQP4-Ab levels over 1 year after the bortezomib administration. While these exciting data expand available therapeutic options for NMOSD, the mechanism of action of bortezomib merits further scrutiny to appropriately influence our understanding of the underlying immunology.

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