Immunoadsorption in steroid-refractory multiple sclerosis.
Multiple sclerosis (MS) is an autoimmune disorder, with involvement of both the humoral and cellular components of the immune system. The use of plasma exchange (PE) in steroid-refractory relapses has become an integral part of national and international guidelines for the treatment of steroid-resistant relapses of MS with an efficacy of 40-70%. So far, 6 studies of immunoadsorption (IA) treatment in different forms of MS have been published, 4 of them in steroid-refractory MS relapses. These 4 studies revealed a significant clinical improvement in 73-85% of patients with steroid-refractory MS relapses. However in MS patients with non-active relapsing-remitting or secondary progressive course, there was no clinical improvement. Despite the limited number of patients and studies, these data suggest a reasonably similar efficacy of IA in the treatment of steroid-refractory MS relapses compared to PE. More prospective trials are needed to confirm and extend these results.
Department of Nephrology and Rheumatology, Georg-August-University Goettingen, Robert-Koch-Str 40, D-37075 Goettingen, Germany. mkoziolek@med.uni-goettingen.de
Michael J
MJ
Koziolek
Bernd
B
Kitze
Johannes
J
Mühlhausen
Gerhard A
GA
Müller
D000042:Absorption; D001323:Autoantibodies / Q000097:blood*; D015551:Autoimmunity; D015415:Biomarkers / Q000097:blood; D001781:Blood Component Removal / Q000009:adverse effects / Q000379:methods*; D004185:Disability Evaluation; D004351:Drug Resistance; D006801:Humans; D007163:Immunosorbent Techniques / Q000009:adverse effects; D007164:Immunosorbents / Q000009:adverse effects / Q000627:therapeutic use*; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000097:blood / Q000175:diagnosis / Q000276:immunology / Q000503:physiopathology / Q000628:therapy*; D010951:Plasma Exchange; D020127:Recovery of Function; D013256:Steroids / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome
D001323:Autoantibodies; D015415:Biomarkers; D007164:Immunosorbents; D013256:Steroids