Therapeutic plasma exchange in steroid-refractory multiple sclerosis relapses. A retrospective two-center study.
autoimmunity
clinical trials observational study (cohort, case control)
multiple sclerosis
plasmapheresis
Journal
Therapeutic advances in neurological disorders
ISSN: 1756-2856
Titre abrégé: Ther Adv Neurol Disord
Pays: England
ID NLM: 101480242
Informations de publication
Date de publication:
2021
2021
Historique:
received:
19
08
2020
accepted:
25
10
2020
entrez:
8
2
2021
pubmed:
9
2
2021
medline:
9
2
2021
Statut:
epublish
Résumé
Therapeutic plasma exchange (TPE) is frequently used in glucocorticosteroid (GCS)-refractory multiple sclerosis (MS) relapses. Data regarding predictors of treatment response are scarce. The objective of this study was to analyze predictive factors for response to TPE in GCS-refractory MS patients. A total of 118 MS patients in two tertiary MS centers were analyzed. Primary outcome was TPE response defined as marked, mild, or no improvement. Secondary outcome was change in expanded disability status scale (ΔEDSS). ΔEDSS and relapse activity within 6 months after TPE were studied. Marked or mild improvement was observed in 78.8% of patients. ΔEDSS correlated significantly inversely with time from relapse to start of TPE (τ = -0.239, Patients with longer disease duration and higher EDSS pre and post-TPE were more likely to show further disability progression or relapses within 6 months after TPE. No sustained effects were observed during the follow-up period.
Sections du résumé
BACKGROUND
BACKGROUND
Therapeutic plasma exchange (TPE) is frequently used in glucocorticosteroid (GCS)-refractory multiple sclerosis (MS) relapses. Data regarding predictors of treatment response are scarce. The objective of this study was to analyze predictive factors for response to TPE in GCS-refractory MS patients.
METHODS
METHODS
A total of 118 MS patients in two tertiary MS centers were analyzed. Primary outcome was TPE response defined as marked, mild, or no improvement. Secondary outcome was change in expanded disability status scale (ΔEDSS). ΔEDSS and relapse activity within 6 months after TPE were studied.
RESULTS
RESULTS
Marked or mild improvement was observed in 78.8% of patients. ΔEDSS correlated significantly inversely with time from relapse to start of TPE (τ = -0.239,
CONCLUSION
CONCLUSIONS
Patients with longer disease duration and higher EDSS pre and post-TPE were more likely to show further disability progression or relapses within 6 months after TPE. No sustained effects were observed during the follow-up period.
Identifiants
pubmed: 33552236
doi: 10.1177/1756286420975642
pii: 10.1177_1756286420975642
pmc: PMC7844455
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1756286420975642Informations de copyright
© The Author(s), 2021.
Déclaration de conflit d'intérêts
Conflict of interest statement: BS, EJ, MS and SA declare that there is no conflict of interest. BG has participated in meetings sponsored by, received speaker honoraria or travel funding from Biogen, Celgene, Merck, Novartis, Sanofi-Genzyme and Teva, and received honoraria for consulting Biogen, Roche and Teva. None of them resulted in a conflict of interest regarding the submitted manuscript. WA, LF, HM and BT declare that there is no conflict of interest with regard to this work. PSR received research grants from Biogen, Merck, Roche; consultancy or speaker fees from Allmiral, Biogen, Cellgene, Merck, Roche, Novartis, Sanofi Genzyme, Sandoz. None of them resulted in a conflict of interest regarding the submitted work. ZUK received speaker fees from Alexion, Allmiral, Bayer, Biogen, Merck, Novartis, Roche, Sanofi Genzyme and Teva. None of them resulted in a conflict of interest regarding the submitted manuscript.
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