The DOI matches its Crossref record; 26 of the 26 references it cites were found in a registry or an index.
Inebilizumab for the treatment of neuromyelitis optica spectrum disorder (N-MOmentum): a double-blind, randomised placebo-controlled phase 2/3 trial
Abstract
Background No approved therapies exist for neuromyelitis optica spectrum disorder (NMOSD), a rare, relapsing, autoimmune, inflammatory disease of the CNS that causes blindness and paralysis. We aimed to assess the efficacy and safety of inebilizumab, an anti-CD19, B cell-depleting antibody, in reducing the risk of attacks and disability in NMOSD. Methods We did a multicentre, double-blind, randomised placebo-controlled phase 2/3 study at 99 outpatient specialty clinics or hospitals in 25 countries. Eligible participants were adults (≥18 years old) with a diagnosis of NMOSD, an Expanded Disability Status Scale score of 8·0 or less, and a history of at least one attack requiring rescue therapy in the year before screening or at least two attacks requiring rescue therapy in the 2 years before screening. Participants were randomly allocated (3:1) to 300 mg intravenous inebilizumab or placebo with a central interactive voice response system or interactive web response system and permuted block randomisation. Inebilizumab or placebo was administered on days 1 and 15. Participants, investigators, and all clinical staff were masked to the treatments, and inebilizumab and placebo were indistinguishable in appearance. The primary endpoint was time to onset of an NMOSD attack, as determined by the adjudication committee. Efficacy endpoints were assessed in all randomly allocated patients who received at least one dose of study intervention, and safety endpoints were assessed in the as-treated population. The study is registered with ClinicalTrials.gov, number NCT02200770. Findings Between Jan 6, 2015, and Sept 24, 2018, 230 participants were randomly assigned to treatment and dosed, with 174 participants receiving inebilizumab and 56 receiving placebo. The randomised controlled period was stopped before complete enrolment, as recommended by the independent data-monitoring committee, because of a clear demonstration of efficacy. 21 (12%) of 174 participants receiving inebilizumab had an attack versus 22 (39%) of 56 participants receiving placebo (hazard ratio 0·272 [95% CI 0·150-0·496]; p<0·0001). Adverse events occurred in 125 (72%) of 174 participants receiving inebilizumab and 41 (73%) of 56 participants receiving placebo. Serious adverse events occurred in eight (5%) of 174 participants receiving inebilizumab and five (9%) of 56 participants receiving placebo. Interpretation Compared with placebo, inebilizumab reduced the risk of an NMOSD attack. Inebilizumab has potential application as an evidence-based treatment for patients with NMOSD. Funding MedImmune and Viela Bio.
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“In any case, the long-term persistence of (re-)activatable autoantigen-specific ThEx cells in patients in remission may well explain the less-than-perfect treatment efficacy of steroid-sparing agents, 64-67 depletion of CD19/CD20 memory B cells, 68,69 as well as exacerbation of disease by b -IFN. 27,70”
From Autoantigen-specific CD4+ T cells acquire an exhausted phenotype and persist in human antigen-specific autoimmune diseases (2024) · cites this paper as [68]
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Revised diagnostic criteria for neuromyelitis optica
Wingerchuk, D. M., Lennon, V. A., Pittock, S. J., Lucchinetti, C. F., & Weinshenker, B. G. (2006) · Neurology · doi:10.1212/01.wnl.0000216139.44259.74 · Cited by 2,568
Self-citationB-cell depletion with rituximab in relapsing-remitting multiple sclerosis
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Self-citationOcrelizumab versus Interferon Beta-1a in Relapsing Multiple Sclerosis
Hauser, S. L., Bar-Or, A., Comi, G., Giovannoni, G., Hartung, H.-P., Hemmer, B., Lublin, F., Montalban, X., Rammohan, K. W., Selmaj, K., et al. (2017) · New England Journal of Medicine · doi:10.1056/nejmoa1601277 · Cited by 2,021
Self-citationOcrelizumab versus Placebo in Primary Progressive Multiple Sclerosis
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Self-citationEculizumab in Aquaporin-4–Positive Neuromyelitis Optica Spectrum Disorder
Pittock, S. J., Berthele, A., Fujihara, K., Kim, H. J., Levy, M., Palace, J. A., Nakashima, I., Terzi, M., Totolyan, N. A., Viswanathan, S., et al. (2019) · New England Journal of Medicine · doi:10.1056/nejmoa1900866 · Cited by 887
Self-citationAn open label study of the effects of rituximab in neuromyelitis optica
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Self-citationIntrathecal pathogenic anti–aquaporin‐4 antibodies in early neuromyelitis optica
Bennett, J. L., Lam, C., Kalluri, S. R., Saikali, P., Bautista, K., Dupree, C., Glogowska, M. J., Case, D., Antel, J. P., Owens, G. P., et al. (2009) · Annals of Neurology · doi:10.1002/ana.21802 · Cited by 593
Self-citationNeuromyelitis optica IgG predicts relapse after longitudinally extensive transverse myelitis
Weinshenker, B. G., Wingerchuk, D. M., Vukusic, S., Linbo, L., Pittock, S. J., Lucchinetti, C. F., & Lennon, V. A. (2006) · Annals of Neurology · doi:10.1002/ana.20770 · Cited by 585
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Items 501–600 of 742
Wan, F., Wu, X., Tan, Y., Guo, Y., Wang, Y., Qiu, W., Shu, Y., & Xiao, L. (2026) · BMC Neurology · doi:10.1186/s12883-026-04648-4 · Cited by 2
“By reducing AQP4-IgG production at the source and inhibiting immune-mediated damage to the central nervous system (CNS) [4, 5], it has now been approved for the treatment of AQP4-IgG + NMOSD patients.”
Alchaki, A. R. (2026) · Neurologic Clinics · doi:10.1016/j.ncl.2025.12.003 · Cited by 2
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Wen, M., Zheng, R., Zhang, H., Goldberg, S. Y., Jian, Z., Gao, Y., Cheng, R., Wen, L., Zhao, Y. Y., Kenderian, S. S., et al. (2026) · Journal of Neuroinflammation · doi:10.1186/s12974-025-03662-6 · Cited by 2
“In this context, it is important to acknowledge the considerably more mature clinical development of several monoclonal antibody therapies that have already achieved regulatory approval and demonstrated robust efficacy in NMOSD [11, 84–86].”
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Neurologic autoimmune diseases
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“Furthermore, a clinical trial demonstrated that a novel medication named inebilizumab successfully decreased the likelihood of relapse in patients who suffer from NMOSD, a rare illness similar to MS [175] .”
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Lara, N. T., Gómez-Ballesteros, R., Sepúlveda, M., Orvíz, A., Díaz-Sánchez, M., Boyero, S., Aguado-Valcárcel, M., Cobo‐Calvo, Á., López-Laiz, P., Rebollo, P., et al. (2024) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2024.105732 · Cited by 2
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“There was no significant reduction in antibody titres to tetanus toxoid; vaccine responses were not assessed [149].”
Ten Years of Neurology ® Neuroimmunology & Neuroinflammation
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“Introduction of the complement inhibitor eculizumab in NMOSD in 2019 was followed shortly by the approval of 2 more treatments for AQP4-seropositive NMOSD, the anti-CD19 B-cell – depleting antibody inebilizumab 155 and the anti-IL-6 receptor satralizumab.”
Self-citationB cell-depleting anti-CD19 monoclonal antibody holds promise for treating IgG4-related cholangitis
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“This anti-CD19 monoclonal antibody targets a wider variety of B-cell lineage lymphocytes compared to anti-CD20 therapies [28].”
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“This approval followed the results from the pivotal N-MOmentum trial, the largest study ever conducted in a real-world spectrum of adults with NMOSD [133].”
Miyake, S., Katsura, Y., Baba, M., Tomizawa-Shinohara, H., Matsumoto, Y., & Serizawa, K. (2025) · Journal of Neuroimmunology · doi:10.1016/j.jneuroim.2025.578644 · Cited by 2
“Nevertheless, even with these medications, a certain proportion of patients still experience relapse (Yamamura et al., 2019; Nakashima et al., 2024; Cree et al., 2019; Pit-tock et al., 2023).”
A recalcitrant case of pemphigus treated with inebilizumab
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“15 Although there are international recommendations for the diagnosis of MOGAD, 16 formal consensus guidelines such as those for NMOSD 1 have yet to be published.”
BackgroundNeuromyelitis Optica Spectrum Disorder: An Early Diagnosis to Prevent Blindness and Paraplegia
George, M., & Gantioque, R. (2023) · The Journal for Nurse Practitioners · doi:10.1016/j.nurpra.2023.104654 · Cited by 2
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“MöglicherweiseerhöhtesRisiko füropportunistische Infektionen(inkl.progressiver multifokaler Leukenzephalopathie); Prophylaxe erwägen (z. B. gegen Pneumocystis jirovecii). nWenn PEX/IA (Plasmapherese/ Immunadsorption), ggf. ECZ-Boost empfohlen; PEX/IA kann auch anderemonoklonale Antikörper eliminieren. oDa NMOSD häufig…”
BackgroundInfluentialAbdel-Wahed, L., & Cho, T. A. (2021) · Seminars in Neurology · doi:10.1055/s-0041-1725152 · Cited by 2
Advances in the Treatment of Neuromyelitis Optica Spectrum Disorder
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“1, 2022 19 환자군에서는 인에빌리주맙 치료군의 12%에서, 위약군의 39%에 서 재발이 관찰되었고, 항체 양성인 환자군에서는 인에빌리주맙 치료군의 11%, 위약군의 42%의 재발이 관찰되어 보다 뚜렷한 차 이를 보였다(Table).(58) 하지만, 항체 음성인 환자군에서는 13명의 인에빌리주맙 치료군의 3명에서 재발이 발생한 반면 위약군에서는 재발이 관찰되지 않았다.”
Neuromyelitis optica spectrum disorder
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Novel and traditional B-cell depleting agents for IgG4-related disease: a critical view
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“the open-label extension of the N-MOmentum study, in which the possibility of PML could not be ruled out.(52) ATZ is an mAb against CD52 that depletes B and T cells.”
BackgroundCD20-mediated B cell depletion in acetylcholine receptor autoantibody-positive myasthenia gravis
Kanatas, P., O’Connor, K. C., & Stathopoulos, P. (2023) · RRNMF Neuromuscular Journal · doi:10.17161/rrnmf.v4i2.19529 · Cited by 1
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“For instance, in patients in the clinical trial of Inebelizumab in NMOSD, asymptomatic optic nerve enhancement was seen on routine imaging (Cree et al. 2019) and if present in MOGAD could suggest a reduced threshold for entry by peripheral CD4 + T-cells and MOG-IgG (Corbali and Chitnis 2023).”
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“NMOSD is a severely disabling disorder that can lead to severe and long-lasting sequelae, including permanent blindness, paralysis, and even death [ 5 ].”
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“In the pivotal N-MOmentum trial, the anti-CD19 monoclonal antibody inebilizumab signi fi cantly reduced attack risk, with sustained bene fi t in long-term follow-up, highlighting the role of CD19 and B-lineage cells in relapse prevention (79, 80).”
Xu, Q., Zhang, L., Duan, X., Zhou, K., Li, Z., Yang, X. L., Wang, J., Jiang, J., Xu, K., Yu, G., et al. (2026) · Neurology Neuroimmunology & Neuroinflammation · doi:10.1212/nxi.0000000000200586 · Cited by 1
“Notably, our infection rate (22.72% [28/110]) exceeded rates in comparable low-dose RTX NMOSD studies (9.09% [5/55]; 0% [0/ 41]).”
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“The annual treatment costs of obinutuzumab β , inebilizumab [33], and rituximab [30] for NMOSD would be approximately RMB 73,000, RMB 155,700, and RMB 75,050, respectively.”
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“Since 2019, four monoclonal antibodies have received approval for the treatment of AQP4-antibody-posi-tive NMOSD: eculizumab, satralizumab, inebilizumab, and ravulizumab [ 16–20 ].”
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Metadata
- Authors
- Cree, B. A. C., Bennett, J. L., Kim, H. J., Weinshenker, B. G., Pittock, S. J., Wingerchuk, D. M., Fujihara, K., Paul, F., Cutter, G. R., Marignier, R., Green, A. J., Aktas, O., Hartung, H.-P., Lublin, F. D., Drappa, J., Barron, G., Madani, S., Ratchford, J. N., She, D., Cimbora, D., & Katz, E.
- Affiliations
- University of California, San Francisco (US)
- University of Colorado Anschutz (US)
- National Cancer Center (KR)
- Mayo Clinic (US)
- Mayo Clinic in Arizona (US)
- Fukushima Medical University (JP)
- Max Delbrück Center (DE)
- University of Alabama at Birmingham (US)
- Hospices Civils de Lyon (FR)
- Heinrich Heine University Düsseldorf (DE)
- Icahn School of Medicine at Mount Sinai (US)
- Corresponding author
- Cree, Bruce A C
- ORCID
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2019-10
- Volume
- 394
- Issue
- 10206
- Pages
- 1352-1363
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W2972221943
- Cited by
- 756
- References
- 26
- Citations by year
- 2026: 105 · 2025: 118 · 2024: 102 · 2023: 101 · 2022: 102 · 2021: 117 · 2020: 101 · 2019: 7
- FWCI
- 58.77
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- MDC Repository (Max-Delbrueck-Center for Molecular Medicine) (submittedVersion)
- Funders
- Hospices Civils de Lyon
- Topics
- Health Sciences › Medicine › Clinical Neurology › Multiple Sclerosis Research Studies
- Health Sciences › Medicine › Clinical Neurology › Peripheral Neuropathies and Disorders
- Health Sciences › Medicine › Ophthalmology › Ocular Diseases and Behçet’s Syndrome
- Keywords
- neuromyelitis optica spectrum disorder, inebilizumab, anti-CD19, B-cell depletion, relapse prevention, disability progression, Expanded Disability Status Scale, treatment-emergent adverse events, autoimmune CNS disease, treatment efficacy and safety, relapse-free survival
- MeSH terms
- Adolescent, Adult, Aged, Double-Blind Method, Female, Hospitalization, Humans, Male, Middle Aged, Neuromyelitis Optica, Prospective Studies, Severity of Illness Index, Treatment Outcome, Young Adult, Antibodies, Monoclonal, Humanized
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