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Real-World Multicenter Cohort Study of Inebilizumab vs Low-Dose Rituximab in Neuromyelitis Optica Spectrum Disorders
Qiao Xu1, Linming Zhang2, Xinyi Duan3,4,5
1Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, China.
Neurology(R) Neuroimmunology & Neuroinflammation
|April 27, 2026
Summary
Inebilizumab significantly reduced relapse risk in neuromyelitis optica spectrum disorder (NMOSD) patients compared to low-dose rituximab (RTX). This B-cell depleting therapy also showed a favorable safety profile, supporting its use in NMOSD treatment.
Area of Science:
- Neurology
- Immunology
- Pharmacology
Background:
- Neuromyelitis Optica Spectrum Disorder (NMOSD) is a rare autoimmune condition affecting the central nervous system.
- Inebilizumab (anti-CD19) and rituximab (RTX, anti-CD20) are B-cell depleting therapies used for NMOSD.
- Real-world data comparing these treatments are limited.
Purpose of the Study:
- To compare the efficacy and safety of inebilizumab versus low-dose RTX in NMOSD patients.
- To assess relapse rates and adverse events in a real-world setting.
- To provide evidence for therapeutic options in NMOSD.
Main Methods:
- Retrospective-prospective multicenter analysis of aquaporin-4 IgG seropositive NMOSD patients in China.
- 119 patients received inebilizumab, and 110 received low-dose RTX (500 mg).
- 1-year follow-up with outcomes analyzed using inverse probability of treatment weighting and doubly robust models.
Main Results:
- Inebilizumab group had significantly lower relapse rates (6.72%) compared to low-dose RTX (21.82%).
- Adjusted annualized relapse rates were lower with inebilizumab (0.06) vs. RTX (0.24).
- Adverse event and serious adverse event rates were similar between groups; infections were less frequent with inebilizumab.
Conclusions:
- Inebilizumab demonstrated superior efficacy in reducing relapse risk in NMOSD patients compared to low-dose RTX.
- Inebilizumab showed a favorable safety profile with comparable adverse event rates.
- Findings support inebilizumab as an effective and well-tolerated treatment option for NMOSD.
