Abstract Details

Title Therapeutic Plasma Exchange in MS relapses: long-term outcome

Topic Multiple Sclerosis

Presentation(s) MS and CNS Inflammatory Disease Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 109

Objective

To determine the functional impact of therapeutic plasma exchange in long-term outcome of patients with Multiple Sclerosis (MS).

Background MS is a chronic autoimmune disease of the Central Nervous System (CNS). In around 85% of cases, the disease has a relapsing remitting course (RRMS) from onset. To date, standard of care treatment of MS relapses is the use of high-dose intravenous methylprednisolone (IVMPS). However, up to 25% of patients persist with significant disability after IVMPS. In this clinical scenario, therapeutic plasma exchange (TPE) is universally accepted, but information about long-term outcome of this treatment is still lacking.

Design/Methods We retrospectively reviewed a cohort of patients with RRMS from 2011 to 2020 in a MS clinic of a referral neurological center in Buenos Aires, Argentina. Cases without clinical improvement after IVMPS infusions (IVMPS-refractory) were divided into two groups: patients who underwent TPE and patients with similar characteristics that did not receive TPE. Groups were matched according to age, sex and disability due to relapse. Disability was measured by the expanded disability status scale (EDSS). All patients were evaluated at time of relapse and during follow up at 1, 3, 6 12 and 24 months. Clinical evolution from both groups was compared.

Results

23 patients (mean age 35 years old) treated with TPE and 21 patients (mean age 37 years old) in the matched control group were included and followed during 24 months. Patients treated with TPE presented lower EDSS/mRs scores at 6 and 24 months (1 vs. 2, p= 0.01; 1 vs. 2, p= 0.01, respectively). No differences were found at 1, 3 and 12 months.

Conclusions TPE treatment in IVMPS-refractory MS relapses is associated with better functional outcome at 6 and 24 months.

Authors/Disclosures
Santiago Crema, Jr., MD (FLENI) PRESENTER	Dr. Crema has received research support from Fundación Dr. Manuel Sadosky - CABA, Argentina .
Mariano Marrodan, MD (Institute for Neurological Research Raul Carrea. Fleni)	Dr. Marrodan has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Dr. Marrodan has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck, Astra Zeneca, Gador, Biogen, Roche and Novartis.
Lucas Alessandro, Sr., MD (FLENI)	Dr. Alessandro has nothing to disclose.
	No disclosure on file
	No disclosure on file
Jorge D. Correale, MD (Institute for Neurological Research)	Dr. Correale has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Correale has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Correale has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Correale has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Correale has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanofi-Genzyme. Dr. Correale has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for ROche. Dr. Correale has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Dr. Correale has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Correale has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Correale has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi-Genzyme. The institution of Dr. Correale has received research support from Merck. The institution of Dr. Correale has received research support from Biogen. The institution of Dr. Correale has received research support from Novartis .
Celica Ysrraelit	Celica Ysrraelit has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Celica Ysrraelit has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Celica Ysrraelit has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. Celica Ysrraelit has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck. Celica Ysrraelit has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Genzyme. Celica Ysrraelit has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Celica Ysrraelit has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Merck, . Celica Ysrraelit has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Biogen. Celica Ysrraelit has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Bayer. Celica Ysrraelit has received research support from Novartis. The institution of Celica Ysrraelit has received research support from ROCHE. The institution of Celica Ysrraelit has received research support from Roche.

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