Abstract Details

Title Effect of therapeutic plasma exchange in treatment of severe multiple sclerosis relapse - a retrospective analysis

Topic Multiple Sclerosis

Presentation(s) P1 - Poster Session 1 (9:00 AM-5:00 PM)

Poster/Presentation
Number 330

Objective

To assess the effect of TPE on EDSS improvement in severe relapse of relapsing-remitting MS (RRMS).

Background

Evidence-based treatment of multiple sclerosis (MS) relapse includes an intravenous administration of 3 to 5g of Methylprednisolone. If corticosteroids are inadequately effective or poorly tolerated, therapeutic plasma exchange (TPE) might be a considered.

Design/Methods

We retrospectively analyzed patients meeting the following criteria: age>18 years, RRMS according to the 2017 McDonald criteria and baseline EDSS<8. Exclusion criteria: progressive form of MS and previous TPE. Observed parameters included: 1) EDSS dynamics (before and after Methylprednisolone, before and after TPE; post-TPE EDSS was assessed during the 8-week follow-up period), 2) EDSS improvement according to the number of TPE procedures and severity of relapse.

Results Our cohort included 155 patients (115/74% females), mean age of 40.3±9.9 years. 131 patients underwent Methylprednisolone treatment plus TPE and 24 patients TPE only [3 TPE in 77, 4 TPE in 29, 5 TPE in 39 and >5 TPE in 10 patients]. The ratio of in-patient vs. outpatient TPE was 44,5 vs. 55,5% and 98,1% patients had TPE via peripheral venous catheter. Mean baseline EDSS was 4.4±1.3 and EDSS after Methylprednisolone was 4.7±1.3. Mean EDSS before TPE was 4.8±4.8 and EDSS after TPE was 4.4±1.3. A significant improvement of EDSS after TPE was observed (p<0.001). There was no difference in EDSS improvement according to age (p=0.94) or number of TPE (p=0.91). We observed a significant EDSS improvement in females: -0.43±0.69 vs. -0.07±1.05 in males, p=0.048.

Conclusions In this retrospective analysis, we observed a significant EDSS improvement after TPE in patients with aggressive relapse and insufficient effect or intolerance of Methylprednisolone. There was no difference in TPE effectiveness according to number of procedures, age and relapse severity. The TPE effect was more prominent in females.

Authors/Disclosures
Radovan Bunganic, MD (University Hospital Ostrava, Neurology Clinic) PRESENTER	Dr. Bunganic has nothing to disclose.
	No disclosure on file
	No disclosure on file
Olga Zapletalova (University Hospital in Ostrava)	No disclosure on file
Pavel Hradilek, MD, PhD (Faculty Hospital Ostrava)	No disclosure on file
	No disclosure on file
	No disclosure on file
Aravind Ganesh	No disclosure on file
	No disclosure on file

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