biostudies-literatureUnknown8(10)Giovannelli J<h4>Objective</h4>As phase III trials have shown interest in innovative but expensive drugs in the treatment of neuromyelitis optica spectrum disorder (NMOSD), data are needed to clarify strategies in the treatment of neuromyelitis optica (NMO). This meta-analysis compares the efficacy of first-line strategies using rituximab (RTX), mycophenolate mofetil (MMF), or azathioprine (AZA), which are still widely used.<h4>Methods</h4>Studies identified by the systematic review of Huang et al. (2019) were selected if they considered at least two first-line immunosuppressants among RTX, MMF, and AZA. We updated this review. The Medline, Cochrane Central Register of Controlled Trials, Embase, and ClinicalTrials databases were queried between November 2018 and April 2020. To be included, the hazard rAnnals of clinical and translational neurology2025-2037https://www.ebi.ac.uk/biostudies/studies/S-EPMC8528466biostudies-literatureA meta-analysis comparing first-line immunosuppressants in neuromyelitis optica.PMC8528466Collongues NAyrignac XPapeix CCohen MKim HJDauchet LMaillart EStellmann JPNEMOS (Neuromyelitis Optica Study Group in Germany), NOMADMUS (Neuromyelitis Optica study Group in France), OFSEP (Observatoire Français de la Sclérose en Plaques) investigatorsAudoin BKim SHDurand-Dubief FGiovannelli JDeschamps RLaplaud DMarignier RGreenberg BMVukusic SKleiter IBourre BMcCreary MZephir HCiron JRuet AfalseA meta-analysis comparing first-line immunosuppressants in neuromyelitis optica.<h4>Objective</h4>As phase III trials have shown interest in innovative but expensive drugs in the treatment of neuromyelitis optica spectrum disorder (NMOSD), data are needed to clarify strategies in the treatment of neuromyelitis optica (NMO). This meta-analysis compares the efficacy of first-line strategies using rituximab (RTX), mycophenolate mofetil (MMF), or azathioprine (AZA), which are still widely used.<h4>Methods</h4>Studies identified by the systematic review of Huang et al. (2019) were selected if they considered at least two first-line immunosuppressants among RTX, MMF, and AZA. We updated this review. The Medline, Cochrane Central Register of Controlled Trials, Embase, and ClinicalTrials databases were queried between November 2018 and April 2020. To be included, the hazard r2021-01-01T00:00:00Z2021 Oct2025-06-01T02:50:31.03Z2025-06-01T02:50:31.03ZS-EPMC85284663450540710.1002/acn3.51451