Therapeutic plasma exchange in steroid-refractory multiple sclerosis relapses. A retrospective two-center study
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 M...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2021-01-01
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| Series: | Therapeutic Advances in Neurological Disorders |
| Online Access: | https://doi.org/10.1177/1756286420975642 |
| _version_ | 1818663135033163776 |
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| author | Stephan Blechinger Johannes Ehler Gabriel Bsteh Alexander Winkelmann Fritz Leutmezer Stefanie Meister Agnes Santer Michael Hecker Thomas Berger Paulus Rommer Uwe Klaus Zettl |
| author_facet | Stephan Blechinger Johannes Ehler Gabriel Bsteh Alexander Winkelmann Fritz Leutmezer Stefanie Meister Agnes Santer Michael Hecker Thomas Berger Paulus Rommer Uwe Klaus Zettl |
| author_sort | Stephan Blechinger |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-17T05:12:02Z |
| format | Article |
| id | doaj.art-ddb51440ce874c2381acfa05a2f0256c |
| institution | Directory Open Access Journal |
| issn | 1756-2864 |
| language | English |
| last_indexed | 2024-12-17T05:12:02Z |
| publishDate | 2021-01-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Neurological Disorders |
| spelling | doaj.art-ddb51440ce874c2381acfa05a2f0256c2022-12-21T22:02:15ZengSAGE PublishingTherapeutic Advances in Neurological Disorders1756-28642021-01-011410.1177/1756286420975642Therapeutic plasma exchange in steroid-refractory multiple sclerosis relapses. A retrospective two-center studyStephan BlechingerJohannes EhlerGabriel BstehAlexander WinkelmannFritz LeutmezerStefanie MeisterAgnes SanterMichael HeckerThomas BergerPaulus RommerUwe Klaus ZettlBackground: 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.https://doi.org/10.1177/1756286420975642 |
| spellingShingle | Stephan Blechinger Johannes Ehler Gabriel Bsteh Alexander Winkelmann Fritz Leutmezer Stefanie Meister Agnes Santer Michael Hecker Thomas Berger Paulus Rommer Uwe Klaus Zettl Therapeutic plasma exchange in steroid-refractory multiple sclerosis relapses. A retrospective two-center study Therapeutic Advances in Neurological Disorders |
| title | Therapeutic plasma exchange in steroid-refractory multiple sclerosis relapses. A retrospective two-center study |
| title_full | Therapeutic plasma exchange in steroid-refractory multiple sclerosis relapses. A retrospective two-center study |
| title_fullStr | Therapeutic plasma exchange in steroid-refractory multiple sclerosis relapses. A retrospective two-center study |
| title_full_unstemmed | Therapeutic plasma exchange in steroid-refractory multiple sclerosis relapses. A retrospective two-center study |
| title_short | Therapeutic plasma exchange in steroid-refractory multiple sclerosis relapses. A retrospective two-center study |
| title_sort | therapeutic plasma exchange in steroid refractory multiple sclerosis relapses a retrospective two center study |
| url | https://doi.org/10.1177/1756286420975642 |
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