title: Plasmapheresis and immunoadsorption in patients with steroid refractory multiple sclerosis relapses.
abstract: Patients suffering from multiple sclerosis (MS) are treated with high-dose intravenous steroids during acute relapses. In case of steroid refractory relapses, patients are treated with plasmapheresis or immunoadsorption. Until now data concerning the efficacy of both procedures are scarce. Visual evoked potentials (VEP), visual acuity and degree of remission of deficits caused by a relapse that had led to admission in MS patients (n = 48) treated with PLEX, IA or both in a single university centre setting were evaluated retrospectively. In a grouped analysis of patients treated with combined PLEX/IA, PLEX or IA alone, patients in all groups profited as assessed by VEP. Visual acuity also showed a trend towards a better performance, but lacked significance. In a subgroup analysis only concerning patients with initially pathological VEP there was a significant beneficial effect in the groups treated with PLEX/IA as well as in the group summarizing all patients. The combination of PLEX and IA provides a valid treatment option in steroid-refractory MS-relapses, and IA should be considered in acute relapses especially in patients with side effect of PLEX.
authors.affiliation: Department of Neurology, St. Josef-Hospital, Ruhr-University Bochum, Gudrunstr. 56, 44791, Bochum, Germany. simon.faissner@rub.de.
authors.forename: Simon
authors.initials: S
authors.lastname: Faissner
authors.affiliation: Department of Neurology, St. Josef-Hospital, Ruhr-University Bochum, Gudrunstr. 56, 44791, Bochum, Germany.
authors.forename: Johanna
authors.initials: J
authors.lastname: Nikolayczik
authors.affiliation: Department of Neurology, St. Josef-Hospital, Ruhr-University Bochum, Gudrunstr. 56, 44791, Bochum, Germany.
authors.forename: Andrew
authors.initials: A
authors.lastname: Chan
authors.affiliation: Department of Neurology, St. Josef-Hospital, Ruhr-University Bochum, Gudrunstr. 56, 44791, Bochum, Germany.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Hellwig
authors.affiliation: Department of Neurology, St. Josef-Hospital, Ruhr-University Bochum, Gudrunstr. 56, 44791, Bochum, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Gold
authors.affiliation: Department of Neurology, St. Josef-Hospital, Ruhr-University Bochum, Gudrunstr. 56, 44791, Bochum, Germany.
authors.forename: Min-Suk
authors.initials: MS
authors.lastname: Yoon
authors.affiliation: Department of Neurology, St. Josef-Hospital, Ruhr-University Bochum, Gudrunstr. 56, 44791, Bochum, Germany. aiden.haghikia@rub.de.
authors.forename: Aiden
authors.initials: A
authors.lastname: Haghikia
mesh_terms: D061605:Administration, Intravenous; D000328:Adult; D001781:Blood Component Removal; D003131:Combined Modality Therapy; D004185:Disability Evaluation; D004351:Drug Resistance; D005074:Evoked Potentials, Visual; D005260:Female; D006801:Humans; D007163:Immunosorbent Techniques; D008297:Male; D009103:Multiple Sclerosis / Q000503:physiopathology / Q000628:therapy*; D010956:Plasmapheresis / Q000379:methods; D012189:Retrospective Studies; D013256:Steroids / Q000008:administration & dosage; D016896:Treatment Outcome; D014792:Visual Acuity
chemical_list: D013256:Steroids
keywords: Immunoadsorption; Immunosuppressive treatment; Multiple sclerosis; Plasma exchange