Indirect Comparison of 3 Monoclonal Antibodies to Treat AQP4+ NMOSD

A study comparing the relative effectiveness of Uplizna (inebilizumab-cdon; Horizon Therapeutics, Dublin, Ireland) versus Soliris (eculizumab; Alexion, Boston, MA) and Enspryng (satralizumab-mwge; Genentech, South San Francisco, CA) demonstrated a decreased risk for NMOSD attack and better results for expected life years and quality adjusted life years for NMOSD patients treated with Uplizna. Uplizna, Soliris, and Enspryng are monoclonal antibodies approved by the FDA for the treatment of AQP4+ NMOSD. The results were presented at the 9th joint meeting of the European and American Committees for Treatment and Research in Multiple Sclerosis (ECTRIMS-ACTRIMS).

Researchers used an anchored matching-adjusted indirect comparison (MAIC) to assess the relative effectiveness of Uplizna treatment from the N-MOmentum clinical trial (NCT02200770) anti-aquaporin-4 antibody positive (AQP4+) population versus Soliris and Enspryng treatment in AQP4+ NMOSD populations from published randomized control trials. The risk of NMOSD attack was defined as time to first investigator adjudicated attack (IAA). Researchers also built a model simulating NMOSD-related mortality based on disease progression to estimate the long-term efficacy of each treatment, presented as life years and quality-adjusted life years.

• The relative risk of experiencing an NMOSD attack for patients treated with Uplizna was 1.51 (CI, 0.70-3.25) vs 0.49 (CI, 0.19-1.28) for patients treated with Enspryng and Soliris.
• The calculated life years and quality adjusted life years were 21.90 and 12.55 for the Uplizna group, 20.79 and 11.34 for the Enspryng group, and 16.02 and 8.23 for the Soliris group.

This study includes researchers affiliated with Horizon Therapeutics, the Max Delbrück Center for Molecular Medicine, Heinrich Heine University Düsseldorf, Incentive, and the UCSF Weill Institute for Neurosciences.