Anti-CD19 monoclonal antibody for systemic lupus erythematosus and neuromyelitis optica spectrum disorder

We read with great interest the recent article by Tsai et al,1 which compared characteristics between primary neuromyelitis optica spectrum disorder (NMOSD) and autoimmune disease–associated neuromyelitis optica spectrum disorder (AD-NMOSD) in a Taiwanese cohort. The authors reported that systemic lupus erythematosus (SLE) was the most common comorbidity and that younger age, longer disease duration and low complement levels were predictive of relapse and severe sequelae. Their findings illustrate the heterogeneity of AD-NMOSD and the need for improved therapeutic strategies in this high-risk subgroup.