A systematic review and meta-analysis of the efficacy and safety of eculizumab in AQP4-IgG-positive neuromyelitis optica spectrum disorder.

What was studied

This review looked at eculizumab in NMOSD. NMOSD is a rare autoimmune disease of the central nervous system. It is linked to AQP4 antibodies. Eculizumab blocks a protein called C5. The review followed PRISMA guidelines. It searched several databases up to March 2026. It included late-stage trials only. The main outcomes were time to relapse and relapse rate.

What they found

Eculizumab cut the risk of relapse. The comparison was with placebo or usual immune drugs. The hazard ratio was 0.07. It also cut the annualized relapse rate. The risk ratio was 0.15. Most people on eculizumab stayed free of relapse. Disability scores stayed stable. Safety looked acceptable.

What it means for patients

The authors say eculizumab lowers relapse rates in AQP4-positive NMOSD. They say it is considered safe.

Why it is not certain yet

Few trials were included. Sample sizes were small. Follow-up differed between trials and was short. Long-term safety data are limited. Cost data are limited too. The authors call for more studies. The abstract gives no numbers for safety events.

Source

A systematic review and meta-analysis of the efficacy and safety of eculizumab in AQP4-IgG-positive neuromyelitis optica spectrum disorder.

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