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Eculizumab + methylprednisolone is a combination therapy regimen being evaluated by the Chinese PLA General Hospital for the treatment of acute attacks in patients with neuromyelitis optica spectrum disorder (NMOSD), specifically those who are aquaporin-4 (AQP4) antibody-positive. Eculizumab is a humanized monoclonal antibody that targets the complement protein C5, inhibiting its cleavage into C5a and C5b and thereby preventing the formation of the membrane attack complex (MAC). This action mitigates the complement-mediated astrocyte damage characteristic of NMOSD. Methylprednisolone is a potent synthetic glucocorticoid used in high-dose intravenous pulses (IVMP) to provide rapid anti-inflammatory and immunosuppressive effects during an acute relapse. The combination aims to enhance clinical recovery and improve functional outcomes beyond the standard of care (corticosteroids alone) during the hyperacute phase of an attack.
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