Objective:To evaluate the efficacy and safety of eculizumab in treating acute attacks of aquaporin-4 antibody(AQP4-IgG)positive neuromyelitis optica spectrum disorder(NMOSD).Methods:Six patients with AQP4-IgG-positive NMOSD treated with eculizumab at the Affiliated Hospital of Qingdao University from August 2023 to April 2024 were included.The patients' clinical characteristics, changes in scores of neurological function, pain and spasm before and after eculizumab treatment, and adverse drug reactions during the treatment period were described, and the data were subjected to Friedman test using SPSS 25.0.Results:The median score of expanded disability status scale in the six patients decreased from 3.25 before treatment to 1.25 after treatment, and the difference was statistically significant ( F=44.77, P<0.01).The functional status score showed noticeable improvement as early as week 1, demonstrating greater sensitivity to treatment response.Three patients experienced moderate to severe pain before treatment, with a mean pain score of 6, which reduced to 4.67 and 1.33 at week 2 and 6, respectively( F=29.17, P<0.05).Two patients reported spasms before treatment, with a mean score of 3.00, which decreased to 2.00, 1.50, and 1.00 at week 2, 3, and 6 after treatment, respectively( F=18.00, P>0.05).No serious adverse reactions were reported during the treatment. Conclusion:Eculizumab can effectively improve the neurological function and alleviate pain in patients with AQP4-IgG-positive NMOSD during acute attacks, and demonstrate good safety.

Objective:To evaluate the efficacy and safety of eculizumab in treating acute attacks of aquaporin-4 antibody(AQP4-IgG)positive neuromyelitis optica spectrum disorder(NMOSD).Methods:Six patients with AQP4-IgG-positive NMOSD treated with eculizumab at the Affiliated Hospital of Qingdao University from August 2023 to April 2024 were included.The patients' clinical characteristics, changes in scores of neurological function, pain and spasm before and after eculizumab treatment, and adverse drug reactions during the treatment period were described, and the data were subjected to Friedman test using SPSS 25.0.Results:The median score of expanded disability status scale in the six patients decreased from 3.25 before treatment to 1.25 after treatment, and the difference was statistically significant ( F=44.77, P<0.01).The functional status score showed noticeable improvement as early as week 1, demonstrating greater sensitivity to treatment response.Three patients experienced moderate to severe pain before treatment, with a mean pain score of 6, which reduced to 4.67 and 1.33 at week 2 and 6, respectively( F=29.17, P<0.05).Two patients reported spasms before treatment, with a mean score of 3.00, which decreased to 2.00, 1.50, and 1.00 at week 2, 3, and 6 after treatment, respectively( F=18.00, P>0.05).No serious adverse reactions were reported during the treatment. Conclusion:Eculizumab can effectively improve the neurological function and alleviate pain in patients with AQP4-IgG-positive NMOSD during acute attacks, and demonstrate good safety.