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Abstract Details

Intravenous Immune Globulins vs Plasma Exchange Usage in Patients with Neuromuscular and Neuro-immunological Conditions
Neuromuscular and Clinical Neurophysiology (EMG)
P4 - Poster Session 4 (8:00 AM-9:00 AM)
11-007
This study examines the pattern of plasma exchange (PLEX) and intravenous immune globulin (IVIg) use for autoimmune neurological disorders at our institution and across the US, focusing on complications in elderly patients.
PLEX and IVIg are commonly employed to treat autoimmune neuromuscular disorders including myasthenia gravis (MG), acute inflammatory demyelinating polyradiculoneuropathy (AIDP), chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and other autoimmune neurological disorders. The side effect profiles of these therapies vary, and their safety profile in the elderly population is not well studied.

We performed a retrospective chart review of adult patients at our institution  receiving PLEX or IVIg for any autoimmune neuromuscular or neuro-immunological diseases. Next, we analyzed the National Inpatient Sample (NIS) database to confirm the trend in IVIg and PLEX use from 2012 to 2018 for a set of neuromuscular and neuro-immunological primary diagnoses based on ICD-9-CM and ICD-10-CM codes.

We did not notice any significant difference in terms of adverse effects of IVIg or PLEX. The adverse effects were similar among elderly patients (age ≥65) compared to younger patients (<65) in our institution, even after adequate matching of patients based on age, sex, and medical history. We examined the NIS dataset to further confirm our findings and a similar trend was identified.

PLEX and IVIG have important therapeutic uses in patients with autoimmune neuromuscular and neuro-immunological diseases. Our study did not identify any significant difference in terms of adverse effects  between elderly and younger patients. Both treatment options are safe choices in adult patients and should be used in appropriate clinical contexts.
Authors/Disclosures
Melissa J. Rethana, MD
PRESENTER 		Dr. Rethana has nothing to disclose.
Adeel Zubair, MD (Yale University School of Medicine) Dr. Zubair has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for The MedNet.
Anthony K. Ma, MD (The Mount Sinai Hospital) Mr. Ma has nothing to disclose.
Lindsay S. McAlpine, MD (Yale University) Dr. McAlpine has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Law Firm. The institution of Dr. McAlpine has received research support from NIH.
Ahmad Abulaban, MD, FAAN (King Abdulaziz Medical City) Dr. Abulaban has nothing to disclose.
Richard J. Nowak, MD (Yale University School of Medicine) Dr. Nowak has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion . Dr. Nowak has received personal compensation in the range of $500-$4,999 for serving as a Consultant for argenx. Dr. Nowak has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UCB. Dr. Nowak has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Immunovant . Dr. Nowak has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cabaletta Bio . Dr. Nowak has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Amgen. Dr. Nowak has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cour Pharma. Dr. Nowak has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono. Dr. Nowak has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janseen . The institution of Dr. Nowak has received research support from UCB. The institution of Dr. Nowak has received research support from Alexion . The institution of Dr. Nowak has received research support from Janseen. The institution of Dr. Nowak has received research support from Immunovant . The institution of Dr. Nowak has received research support from argenx. The institution of Dr. Nowak has received research support from Amgen. Dr. Nowak has a non-compensated relationship as a Member of the Board of Directors with Myasthenia Gravis Foundation of America (MGFA) that is relevant to AAN interests or activities.
Bhaskar Roy, MD, FAAN (Yale University) Dr. Roy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for argenx. Dr. Roy has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. Dr. Roy has stock in Cabaletta bio. . Dr. Roy has stock in Pfizer. Dr. Roy has stock in CAVA. The institution of Dr. Roy has received research support from Abcuro Pharmaceuticals. The institution of Dr. Roy has received research support from Immunovant. The institution of Dr. Roy has received research support from argenx.