Lack of response to pulse cyclophosphamide in neuromyelitis optica: evaluation of 7 patients.

T he effect of immunosuppression with corticosteroids, azathioprine, mycophenolate, or rituximab for preventing relapses in patients with neuromyelitis optica (NMO) has been demonstrated in case series and retrospective studies. These drugs are currently considered the mainstay treatment for preventing neurologic worsening in NMO. Herein, we describe our experience with pulse cyclophosphamide for treating patients with NMO, which was used prior to azathioprine and had its use interrupted owing to lack of efficacy.