Preventative Treatment of NMO-SD and MOG antibody associated diseases
Cellcept:
CellCept (Mycophenolate mofetil) is an oral immunosuppressant. It inhibits an enzyme in the body that contributes to the production of specific purines. These purines are necessary for certain white blood cells, specifically T- and B-cells, to carry out an attack against offending material. This leads to less damage of myelin and neurons in the brain.
How it’s Given
CellCept is a pill that is taken by mouth. It should be taken one hour before or two hours after food for best absorption. Tablets should not be crushed, chewed, or cut and capsules should not be opened. Tablets and capsules should be swallowed whole. A solution is also available for younger children.
Certain medications interact with the absorption of CellCept and should not be given at the same time. These include the following:
• Avoid taking antacids containing aluminum or magnesium (i.e. Maalox®, Mylanta®) at the same time as mycophenolate as these will affect how much drug you absorb. It should be taken at least one hour before or two hours after taking antacids.
• Avoid taking calcium supplements or iron supplements at the same time as mycophenolate as these will affect how much drug you absorb. It should be taken at least one hour before or two hours after taking these supplements.
• Make sure to contact your doctor prior to starting any new medications
Common Side effects include: increased risk of infection, nausea, stomach pain, diarrhea (increasing the dose slowly reduces these effects), weakness, dizziness, difficulty sleeping and increased liver function tests.
Rituximab:
Rituximab (Rituxan) is an intravenous immunosuppressant. It is an antibody to a population of immune cells called B cells. B cells cooperate with T cells to cause attack on the myelin, neurons or other cells in the brain. Rituximab is used as a treatment for MS, NMO-SD and MOG-antibody associated diseases in children.
How it’s Given
• Rituximab is given by intravenous infusion approximately every 6 months. The exact duration between treatments may be tailored to the specific patient and situation. Usually the first dose is administered in two half doses, two weeks apart.
• Rituximab is usually given along with intravenous steroids, antihistamines and antacids to prevent infusion or allergic reactions.
• Rituximab infusions are usually given in an infusion unit by trained nursing staff.
• Make sure to contact your doctor prior to starting any new medications
Common Side effects include: infusion reactions including rash, tireness, rarely breathing difficulties. Longterm side effects include increased risk of infection, nausea, stomach pain, diarrhea (increasing the dose slowly reduces these effects), weakness, dizziness, difficulty sleeping and increased liver function tests.