Study of Mitoxantrone for the Treatment of Recurrent Neuromyelitis Optica (Devic Disease)

Abstract

Neuromyelitis optica (NMO), also known as Devic disease, is a severe demyelinating condition that selectively affects the optic nerves and the spinal cord with relative sparing of the brain. The disease is characterized by monophasic or recurrent attacks of severe optic neuritis and/or extensive longitudinal myelitis; the cerebrospinal fluid findings typically include polymorphonuclear pleocytosis without intrathecal immunoglobulin secretion or oligoclonal bands.¹ By magnetic resonance (MR) imaging, NMO with recurrent attacks (RNMO) can be distinguished from multiple sclerosis (MS) by its extensive spinal cord involvement (≥3 segments of spinal cord gray and white matter) and a paucity of brain findings.¹ Pathologic and serologic data support a B-cell–mediated mechanism that underscores its distinction from classic MS.^2,3