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Therapeutic plasma exchange in steroid-refractory multiple sclerosis relapses. A retrospective two-center study.
Blechinger, Stephan; Ehler, Johannes; Bsteh, Gabriel; Winkelmann, Alexander; Leutmezer, Fritz; Meister, Stefanie; Santer, Agnes; Hecker, Michael; Berger, Thomas; Rommer, Paulus; Zettl, Uwe Klaus.
Afiliación
  • Blechinger S; Department of Neurology, Medical University of Vienna, Vienna, Austria.
  • Ehler J; Department of Anaesthesiology and Intensive Care Medicine, Rostock University Medical Center, Rostock, Germany.
  • Bsteh G; Department of Neurology, Medical University of Vienna, Vienna, Austria.
  • Winkelmann A; Department of Neurology, Rostock University Medical Center, Rostock, Germany.
  • Leutmezer F; Department of Neurology, Medical University of Vienna, Vienna, Austria.
  • Meister S; Department of Neurology, Rostock University Medical Center, Rostock, Germany.
  • Santer A; Department of Neurology, Medical University of Vienna, Vienna, Austria.
  • Hecker M; Department of Neurology, Rostock University Medical Center, Rostock, Germany.
  • Berger T; Department of Neurology, Medical University of Vienna, Vienna, Austria.
  • Rommer P; Department of Neurology, Medical University of Vienna, Spitalgasse 23, Vienna 1090, Austria.
  • Zettl UK; Department of Neurology, Rostock University Medical Center, Rostock, Germany.
Ther Adv Neurol Disord ; 14: 1756286420975642, 2021.
Article en En | MEDLINE | ID: mdl-33552236
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: 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: 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, p = 0.001), age (τ = 0.182, p = 0.009) and disease duration (τ = -0.167, p = 0.017). In multivariate analysis, TPE response was predicted by diagnosis of relapsing MS [odds ratio (OR): 3.1], gadolinum-enhancement on magnetic resonance imaging (OR 3.2), age (OR 0.5 per 5 years older) and time from relapse onset to TPE (OR 0.7 per 7 days longer). CONCLUSION: 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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies / Risk_factors_studies Idioma: En Revista: Ther Adv Neurol Disord Año: 2021 Tipo del documento: Article País de afiliación: Austria Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies / Risk_factors_studies Idioma: En Revista: Ther Adv Neurol Disord Año: 2021 Tipo del documento: Article País de afiliación: Austria Pais de publicación: Reino Unido