{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T06:04:44Z","timestamp":1789452284131,"version":"build-2803163510"},"reference-count":14,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Complement activation plays a key role in the pathogenesis of neuromyelitis optica spectrum disorder (NMOSD). While eculizumab effectively prevents relapses, its role in acute attacks remains uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 38 patients with acute NMOSD treated with eculizumab across seven tertiary hospitals in China. Neurological assessments included EDSS, visual, motor, and sensory deficits, evaluated at baseline and weekly through 8 weeks. Clinical improvement was defined using prespecified criteria. Safety and adverse events were recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients were predominantly female (92.1%) with a mean age of 47.5 \u00b1 14 years. Median EDSS decreased from 4 (IQR 3\u20136.88) to 3 (IQR 2\u20136) at the 4\u20138-week follow-up assessment (p = 5.45 \u00d7 10\n                      <jats:sup>-6<\/jats:sup>\n                      ), with improvement observed in at least one neurological domain in 35\/38 patients (92.1%). Improvement was more frequent in visual (83.3%) and motor function (88.8%) than in sensory function (31.6%). The median time to first improvement was 2 weeks, with cumulative probabilities of 47.4%, 55.3%, and 71.1% at weeks 1, 2, and 4, respectively. In exploratory analyses, the ON+TM phenotype was associated with a lower likelihood of improvement after adjustment for age and baseline EDSS. Four patients experienced mild adverse events, and one patient with a baseline EDSS of 9 died from septic shock.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This exploratory study observed neurological improvement following eculizumab initiation in patients with NMOSD attacks, but serious infections can occur in severely disabled patients, highlighting the need for careful monitoring and patient selection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1917016","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T05:33:36Z","timestamp":1789450416000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Complement C5 inhibitor as a rescue therapy for acute NMOSD attacks: a multicenter retrospective cohort study in China"],"prefix":"10.3389","volume":"17","author":[{"given":"Tao","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Neurology, Peking University First Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Decai","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Neurology, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dehui","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Medical Center of Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Medical Center of Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Zhen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Inner Mongolia People\u2019s Hospital","place":["Hohhot, Inner Mongolia, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Neurology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Neurology, The Second Hospital of Lanzhou University","place":["Lanzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingli","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Beijing Renhe Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology, Peking University First Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiqiang","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Neurology, Peking University First Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiming","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Neurology, Peking University First Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaoxia","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Peking University First Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ran","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Peking University First Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Neurology, Peking University First Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1038\/s41582-024-01014-1","article-title":"Nmosd and mogad: an evolving disease spectrum","volume":"20","author":"Uzawa","year":"2024","journal-title":"Nat Rev Neurol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1177\/11795735241231094","article-title":"Advances in the long-term treatment of neuromyelitis optica spectrum disorder","volume":"16","author":"Anderson","year":"2024","journal-title":"J Cent Nerv Syst Dis"},{"key":"B3","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1186\/s12974-021-02249-1","article-title":"Neuromyelitis optica spectrum disorders: from pathophysiology to therapeutic strategies","volume":"18","author":"Carnero Contentti","year":"2021","journal-title":"J Neuroinflamm"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-024-12426-w","article-title":"Moving towards a new era for the treatment of neuromyelitis optica spectrum disorders","volume":"271","author":"Preziosa","year":"2024","journal-title":"J Neurol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1097\/bor.0000000000000603","article-title":"Treatment of neuromyelitis optica spectrum disorders","volume":"31","author":"Romeo","year":"2019","journal-title":"Curr Opin Rheumatol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1002\/ana.24554","article-title":"Neuromyelitis optica: evaluation of 871 attacks and 1,153 treatment courses","volume":"79","author":"Kleiter","year":"2016","journal-title":"Ann Neurol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-020-01297-w","article-title":"Eculizumab: a review in neuromyelitis optica spectrum disorder","volume":"80","author":"Frampton","year":"2020","journal-title":"Drugs"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2021.696387","article-title":"Eculizumab pharmacokinetics and pharmacodynamics in patients with neuromyelitis optica spectrum disorder","volume":"12","author":"Singh","year":"2021","journal-title":"Front Neurol"},{"key":"B9","doi-asserted-by":"crossref","DOI":"10.3389\/fimmu.2025.1645401","article-title":"Eculizumab for the acute attack of neuromyelitis optica spectrum disorder","volume-title":"Original Research. Frontiers in Immunology","author":"Zhuang","year":"2025"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.73205","article-title":"The efficacy of eculizumab in the acute phase of neuromyelitis optica spectrum disorder: a case series study","volume":"16","author":"Watanabe","year":"2024","journal-title":"Cureus"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1177\/13524585241283650","article-title":"Acute eculizumab treatment in a pediatric patient with AQP4-IgG+ NMOSD","volume":"31","author":"Soni","year":"2025","journal-title":"Mult Scler"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1212\/nxi.0000000000200548","article-title":"Complement inhibition for acute neuromyelitis optica spectrum disorder attacks: insights from an international case series","volume":"13","author":"Rommer","year":"2026","journal-title":"Neurol Neuroimmunol Neuroinflamm"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.0000000000001729","article-title":"International consensus diagnostic criteria for neuromyelitis optica spectrum disorders","volume":"85","author":"Wingerchuk","year":"2015","journal-title":"Neurology"},{"key":"B14","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1186\/s40478-025-02019-7","article-title":"Complement inhibition rapidly blocks lesion extension and facilitates remyelination in neuromyelitis optica","volume":"13","author":"Given","year":"2025","journal-title":"Acta Neuropathol Commun"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1917016\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T05:33:37Z","timestamp":1789450417000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1917016\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,15]]},"references-count":14,"alternative-id":["10.3389\/fimmu.2026.1917016"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2026.1917016","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,15]]},"article-number":"1917016"}}