Satralizumab might not be enough. Olamkicept (sgp130Fc) in Neuromyelitis Optica Spectrum Disorder

•Satralizumab, an antibody against IL-6R, has been recently approved in Neuromyelitis Optica Spectrum Disorder(NMOSD).•Targeting IL-6 and IL-6 receptor (as it happens with Satralizumab) results in inhibition of both pro and anti-inflammatory pathways of IL-6. The detrimental role of IL-6 in NMOSD could be played by the trans-signaling pathway (the pro-inflammatory one).•sgp130Fc(Olamkicept) is a monoclonal antibody that prevents only the pro-inflammatory pathway of IL-6 to be activated, it could be a better way to target IL-6 pathway in Neuromyelitis Optica Spectrum Disorder.