Immunoadsorption versus plasma exchange versus combination for treatment of myasthenic deterioration
| Autor: | Klaus V. Toyka, Behrouz Mansouri-Thalegani, Ralf Gold, Marco Krenzer, Christiane Schneider-Gold, Wolfgang Müllges, Erdmute Klinker |
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| Rok vydání: | 2016 |
| Předmět: |
Pharmacology
medicine.medical_specialty business.industry Myasthenic crisis Urology 030204 cardiovascular system & hematology medicine.disease Myasthenia gravis 03 medical and health sciences 0302 clinical medicine Neurology Immunology medicine Neurology (clinical) Immunoadsorption business 030217 neurology & neurosurgery Original Research |
| Zdroj: | Therapeutic Advances in Neurological Disorders. 9:297-303 |
| ISSN: | 1756-2864 |
| Popis: | Objectives: The goal of this study was to analyze safety and assess the efficacy of standard plasma exchange (PE) compared with immunoadsorption (IA) alone, or an alternating combination of both in deteriorating myasthenia gravis (MG). Methods: A total of 72 patients with MG who had received PE procedures for treatment of severe deterioration were retrospectively analyzed. They received either five cycles of PE (1–1.5 plasma volumes), or five cycles of IA in line with plasma separation, or a sequential alternating procedure of one cycle of PE followed by two cycles of IA, which was repeated once or more if needed. Results: A total of 19 patients received PE, 24 patients IA, and 29 the alternating combination therapy. All groups were equally distributed by sex and mean MG score before treatment. The number of treatment cycles and days on therapy did not differ between the groups. Mean MG scores at discharge were 3.0 (PE), 1.8 (IA) and 1.6 (combination) ( p = 0.028 for combination versus PE). Inpatient time was 30.7 days (PE), 22.3 days (IA) and 20.0 days in combination therapy ( p < 0.05 for combination versus PE). Side effects such as allergic reactions or hypocoagulability were significantly more frequent in the PE group (37% in PE versus 4% in IA and 3.6% in the alternating combination, p < 0.05). Conclusion: Semiselective IA in combination with PE, and to a lesser extent IA alone, was associated with a shorter hospital stay and more pronounced reduction of the MG score than PE. |
| Databáze: | OpenAIRE |
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