Immunadsorption und Plasmapherese in der Behandlung von Multipler Sklerose und Neuromyelitis Optica

Immunoadsorption and plasmapheresis in treatment of multiple sclerosis and neuromyelitis optica

by Johannes Mühlhausen
Doctoral thesis
Date of Examination:2017-03-07
Date of issue:2017-02-14
Advisor:Prof. Dr. Michael Koziolek
Referee:Prof. Dr. Michael Koziolek
Referee:Prof. Dr. Peter Huppke
Persistent Address: http://dx.doi.org/10.53846/goediss-6131

 

 

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Abstract

English

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
 
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