Satralizumab might not be enough. Olamkicept (sgp130Fc) in Neuromyelitis Optica Spectrum Disorder

Satralizumab, the monoclonal antibody against IL-6R, has been approved not long ago in Neuromyelitis Optica Spectrum Disorder (NMOSD). Nonetheless, inhibiting IL-6 Receptor might not be enough, since Satralizumab results in inhibition of both pro and antiinflammatory pathways of IL-6. The detrimental role of IL-6 in NMOSD could be mainly played by the trans-signaling. Olamkicept (sgp130Fc) is a monoclonal antibody that prevents only the trans-signaling pathway of IL-6 to be activated. Targeting only the trans-signaling pathway (the pro-inflammatory one) with Olamkicept/sgp130Fc could lead to avoidance of potential harmful effect of global IL-6 blockade such as profound immunosuppression and it could also mean leaving the “good side” of IL-6 on, while turning the "bad side" off.