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Therapeutic plasma exchange in MS refractory relapses: Long-term outcome
M Marrodan1, S Crema1, A Rubstein2
1Department of Neurology. Fleni. Buenos Aires, Argentina.
Multiple Sclerosis and Related Disorders
|July 31, 2021
Summary
Therapeutic plasma exchange (TPE) offers long-term clinical improvement for steroid-refractory multiple sclerosis (MS) relapses. This safe treatment reduced disability in relapsing-remitting MS patients over 24 months.
Area of Science:
- Neurology
- Immunology
Background:
- Steroid-refractory multiple sclerosis (MS) relapses present a treatment challenge.
- Therapeutic plasma exchange (TPE) is a potential therapeutic option for these refractory cases.
Purpose of the Study:
- To evaluate the long-term clinical response and safety of TPE in patients with steroid-refractory MS relapses.
- To compare outcomes in TPE-treated patients versus a control group not receiving TPE.
Main Methods:
- Retrospective analysis of relapsing-remitting MS (RRMS) patients undergoing TPE for IV methylprednisolone-refractory relapses.
- Comparison with a control group of RRMS patients with similar characteristics not treated with TPE.
- Assessment of clinical response at multiple time points (1-24 months) and multivariate regression for outcome predictors.
Main Results:
- 78% of TPE-treated patients showed clinical improvement at 24 months.
- TPE treatment was associated with lower Expanded Disability Status Scale (EDSS) scores at 6 and 24 months.
- Younger age, gadolinium-enhancing lesions, and TPE were linked to better outcomes; no severe side effects were reported.
Conclusions:
- Therapeutic plasma exchange (TPE) is a safe and well-tolerated procedure for managing steroid-refractory MS relapses.
- TPE demonstrates efficacy in reducing long-term disability in RRMS patients with refractory exacerbations.
