Latin American consensus recommendations for management and treatment of neuromyelitis optica spectrum disorders in clinical practice.

Background: During the last two decades, neuromyelitis optica spectrum disorder (NMOSD) has undergone important changes, with new diagnostic markers and criteria, better recognition of clinical phenotypes, better disease prognosis and new therapeutic approaches. Consequently, management of NMOSD patients in Latin American (LATAM) has become more complex and challenging in clinical practice. In making these consensus recommendations, the aim was to review how the disease should be managed and treated among LATAM patients, in order to improve long-term outcomes in these populations.
Methods: A panel of LATAM neurologists who are experts in demyelinating diseases and dedicated to management and care of NMOSD patients gathered virtually during 2019 and 2020 to make consensus recommendations on management and treatment of NMOSD patients in LATAM. To achieve this consensus, the RAND/UCLA methodology for reaching formal consensus was used.
Results: The recommendations focused on diagnosis and differential diagnoses, disease prognosis, tailored treatment, identification of suboptimal treatment response and special circumstances management. They were based on published evidence and expert opinions.
Conclusions: The recommendations of these consensus guidelines seek to optimize management and specific treatment of NMOSD patients in LATAM.
Competing Interests: Declaration of Competing Interest EC has received reimbursement for developing educational presentations, educational and research grants, consultation fees and/or travel stipends from Biogen, Genzyme, Merck and Novartis. JIR has received honoraria from Novartis as a scientific advisor. He has received travel grants and attended courses and conferences on behalf of Merck-Serono Argentina, Novartis Argentina EC has received reimbursement for developing educational presentations, educational and research grants, consultation fees and/or travel stipends from Biogen, Novartis, Genzyme, Merck and Roche. VDM has received reimbursement for developing educational presentations, educational and research grants, consultation fees and/or travel stipends from Biogen Idec, Merck-Serono, Novartis, Roche, Sanofi-Genzyme, Teva. JFR has nothing to disclose. MLP has received reimbursement for developing educational presentations, educational and research grants, and travel stipends from Biogen Idec, Roche, Novartis and Sanofi-Aventis. CN has nothing to disclose. RPA has received reimbursement for developing educational presentations, educational and research grants, consultation fees and/or travel stipends from the following pharmaceuticals industries: Teva, Novartis, Roche, Merck, Biogen and Sanofi. DKS has received research support from CNPq/Brazil (425331/2016-4 and 308636/2019-8), FAPERGS/MS/CNPq/SESRS (17/2551-0001391-3) PPSUS/Brazil, TEVA, Merck and Euroimmun AG for investigator-initiated studies; has received speaker honoraria from Biogen, Novartis, Genzyme, TEVA, Merck, Roche and Bayer and has participated in advisory boards for Shire, Roche, TEVA, and Merck. ISC has received reimbursement for developing educational presentations, educational and research grants, consultation fees and/or travel stipends from the following pharmaceuticals industries: Teva, Bayer, and Biogen. JC is a board member of Merck-Serono Argentina, Novartis Argentina, Genzyme LATAM, Genzyme global, Biogen-Idec LATAM and Merck-Serono LATAM. He is part of the Steering Committee for the clinical trials of Ofatumumab (Novartis Global). JC has received reimbursement for developing educational presentations for Merck-Serono Argentina, Merck-Serono LATAM, Biogen-Idec Argentina, Genzyme Argentina, Novartis Argentina, Novartis LATAM, Novartis Global and Roche Argentina, as well as professional travel/accommodation stipends.
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