Introduction: Recent research has shown that IL-6 receptor (IL-6 R) inhibitors 
like tocilizumab and satralizumab are effective in reducing the relapse rate in 
patients with NMOSD.Areas covered: This review article explores current concepts 
in NMOSD management and focuses on IL-6 R as a therapeutic target. The authors 
delve into the biological and immunological role of IL-6 in the pathogenesis of 
NMOSD. Further, the authors summarize the most recent findings on the use of 
anti-IL-6 R monoclonal antibodies, tocilizumab and satralizumab, in the 
treatment of NMOSD.Expert opinion: A better understanding of the role of 
cytokines in NMOSD may provide the neurologist with novel therapies for this 
disease. IL-6 R appears to be a central hub to NMOSD pathogenesis and a relevant 
therapeutic target.