Immunoadsorption or plasma exchange in steroid-refractory multiple sclerosis and neuromyelitis optica.
Adult
Age Factors
Blood Component Removal
Female
Humans
Immunosorbent Techniques
/ adverse effects
Male
Middle Aged
Multiple Sclerosis
/ therapy
Multiple Sclerosis, Relapsing-Remitting
Neuromyelitis Optica
/ therapy
Plasma Exchange
/ adverse effects
Prognosis
Recurrence
Retrospective Studies
Steroids
/ pharmacology
Time-to-Treatment
apheresis
immunoadsorption
multiple sclerosis
neuromyelitis optica
plasma exchange
Journal
Journal of clinical apheresis
ISSN: 1098-1101
Titre abrégé: J Clin Apher
Pays: United States
ID NLM: 8216305
Informations de publication
Date de publication:
Aug 2019
Aug 2019
Historique:
received:
01
11
2018
revised:
13
01
2019
accepted:
14
01
2019
pubmed:
31
1
2019
medline:
16
1
2020
entrez:
31
1
2019
Statut:
ppublish
Résumé
Plasma exchange (PE) and immunoadsorption (IA) are alternative treatments of steroid-refractory relapses of multiple sclerosis (MS) or neuromyelitis optica (NMO). Adverse events and neurological follow-ups in 127 MS- (62 PE, 65 IA) and 13 NMO- (11 PE, 2 IA) patients were retrospectively analyzed. Response was defined by improvements in either expanded disability status scale (EDSS) by at least 1.0 or visual acuity (VA) to 0.5, confirmed after 3 and/or 6 months. Hundred and forty patients were included in safety analysis, 102 patients provided sufficient neurological follow-up-data. There were no significant differences between IA and PE in side effects (3.9% vs 3.6%, P = .96) or response-rate (P = .65). Responders showed significant lower age (P = .02) and earlier apheresis-initiation (P = .01). Subgroup-analysis confirmed significant lower age in patients with relapsing-remitting MS (RRMS) /clinical isolated syndrome (CIS). IA and PE seem equally safe and effective in steroid-resistant MS- or NMO-relapses. Early apheresis and low patient age are additional prognostic factors.
Sections du résumé
BACKGROUND
BACKGROUND
Plasma exchange (PE) and immunoadsorption (IA) are alternative treatments of steroid-refractory relapses of multiple sclerosis (MS) or neuromyelitis optica (NMO).
METHODS
METHODS
Adverse events and neurological follow-ups in 127 MS- (62 PE, 65 IA) and 13 NMO- (11 PE, 2 IA) patients were retrospectively analyzed. Response was defined by improvements in either expanded disability status scale (EDSS) by at least 1.0 or visual acuity (VA) to 0.5, confirmed after 3 and/or 6 months.
RESULTS
RESULTS
Hundred and forty patients were included in safety analysis, 102 patients provided sufficient neurological follow-up-data. There were no significant differences between IA and PE in side effects (3.9% vs 3.6%, P = .96) or response-rate (P = .65). Responders showed significant lower age (P = .02) and earlier apheresis-initiation (P = .01). Subgroup-analysis confirmed significant lower age in patients with relapsing-remitting MS (RRMS) /clinical isolated syndrome (CIS).
CONCLUSION
CONCLUSIONS
IA and PE seem equally safe and effective in steroid-resistant MS- or NMO-relapses. Early apheresis and low patient age are additional prognostic factors.
Substances chimiques
Steroids
0
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
381-391Informations de copyright
© 2019 Wiley Periodicals, Inc.