Abstract Details

Title The Incidence of Adverse Effects Following Plasmapheresis Compared to IVIG in Patients with Neuromuscular Diseases

Topic Muscle Disease/Neuromuscular Junction

Presentation(s) P02 - (-)

Poster/Presentation
Number 196

Objective

Background BACKGROUND: Plasmapheresis is shown to be as effective as IVIG in treating many autoimmune neuromuscular disorders. However, it is mostly used as a second line therapy due to its frequent need of a central vascular access, perceived high rate of complications, and relative inaccessibility. Reported side-effects are mostly derived from high-risk patients with hematological disorders.

Design/Methods DESIGN/METHODS: We retrospectively reviewed data on patients treated with plasmapheresis for different neuromuscular diseases from 2009-2012 at the Nerve and Muscles Center of Texas. Data about IVIG adverse events were obtained from the published, peer-reviewed literature.

Results RESULTS: We identified 45 patients who received a total of 854 plasmapheresis sessions. 10.6% of treatments were associated with side effects (vs. 10-34.4% following IVIG infusions) Serious side effects occurred in only 1.4% of treatments (vs. 0.8-1% following IVIG transfusions). No fatalities occurred. 4% of the complications were vascular access related (VAR) and were effectively treated. Of the non-VAR complications, hypotension was the most common (3.4%) followed by anemia (1.8%). Hypotension was effectively treated with normal saline.

Conclusions CONCLUSIONS: Adverse events associated with plasmapheresis are infrequent and mostly mild and treatable. The incidence of overall and severe side effects associated with plasmapheresis and IVIG are fairly comparable. Close monitoring can potentially decrease the occurrence of these side effects. Outpatient plasmapheresis for treatment of neuromuscular diseases is well tolerated and should be given at least an equal consideration to IVIG.

Authors/Disclosures
PRESENTER	No disclosure on file
Gavin Giovannoni, MD (QMUL)	Dr. Giovannoni has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Giovannoni has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Sanofi. Dr. Giovannoni has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Merck KGaA. Dr. Giovannoni has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche-Genentech. Dr. Giovannoni has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Moderna. Dr. Giovannoni has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sandoz. Dr. Giovannoni has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Astoria Biologica. Dr. Giovannoni has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Zenas. Dr. Giovannoni 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. Giovannoni 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. Giovannoni has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Giovannoni has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Medscape.
	No disclosure on file
Aziz I. Shaibani, MD, FAAN (Houston Neurocare, PA)	Dr. Shaibani has nothing to disclose.

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