Immunadsorption und Plasmapherese in der Behandlung von Multipler Sklerose und Neuromyelitis Optica
Immunoadsorption and plasmapheresis in treatment of multiple sclerosis and neuromyelitis optica
von Johannes Mühlhausen
Datum der mündl. Prüfung:2017-03-07
Erschienen:2017-02-14
Betreuer:Prof. Dr. Michael Koziolek
Gutachter:Prof. Dr. Michael Koziolek
Gutachter:Prof. Dr. Peter Huppke
Dateien
Name:Dissertation JM final ohne CV ediss.pdf
Size:1.47Mb
Format:PDF
Zusammenfassung
Englisch
Background: Plasma exchange (PE) and immunoadsorption (IA) are alternative treatments of steroid-refractory relapses of multiple sclerosis (MS) or neuromyelitis optica (NMO). Methods: Adverse events and neurological follow-ups in 127 MS- (62 PE, 65 IA) and 13 NMO- (11 PE, 2 IA) patients were retrospectively analysed. Response was defined by improvements in either expanded disability status scale (EDSS) by at least 1.0 or visual acuity (VA) to 0.5, confirmed after 3 and/or 6 months. Results: 140 patients were included in safety analysis, 102 patients provided sufficient neurological follow-up-data. There were no significant differences between IA and PE in side effects (3.9% vs. 3.6%, p=0.96) or response-rate (p=0.65). Responders showed significant lower age (p=0.02) and earlier apheresis-initiation (p=0.01). Subgroup-analysis confirmed significant lower age in patients with relapsing-remitting MS (RRMS) /clinical isolated syndrome (CIS). Conclusion: IA and PE seem equally safe and effective in steroid-resistant MS- or NMO-relapses. Early apheresis and low patient age are additional prognostic factors.
Keywords: apheresis; immunoadsorption; plasma exchange; multiple sclerosis; neuromyelitis optica
Schlagwörter: Apherese; Plasmapherese; Immunadsorption; Multiple Sklerose; Neuromyelitis Optica