What if relapses occur despite AZT and steroids?
This is a difficult but common situation. A variety of other drugs have been found to be useful in NMO and related disorders Other immunosuppressants -Mycophenolate28 ( Cellcept) Mitoxantrone( Novantrone)29 a widely used chemotherapy drug Rituximab- (Rituxan) a monoclonal antibody against the B cells has been recently shown to be very effective in preventing relapses 30. Some other drugs that have been tried are: Methotrexate20, cyclosporine, cyclophosphamide31, intravenous immunoglobulins32 All of these drugs have side effects. They have been used for only in small number of patients and neurologists cant say much about effectiveness or long-term side effects yet. Larger trials are needed to find definitive answers. 42. Are drugs for preventing attacks of MS, such as interferons and glatiramer acetate (copaxone), useful in NMO? As MS and NMO seem to be different but related diseases with different pathologic mechanisms, they may not be useful. There are reports of benefit with Copaxon
