Abstract Details

Title Comparison of Efficacy between Human Albumin and Fresh Frozen Plasma as Replacement Fluids in Therapeutic Plasma Exchange for Central Demyelinating Diseases

Topic Autoimmune Neurology

Presentation(s) P1 - Poster Session 1 (8:00 AM-9:00 AM)

Poster/Presentation
Number 2-010

Objective To compare the efficacy of albumin and fresh frozen plasma (FFP) as replacement fluids in therapeutic plasma exchange (TPE) for neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS).

Background TPE is an established rescue therapy for steroid-refractory relapses in NMOSD and MS, but the optimal replacement fluid—albumin or FFP—remains uncertain.

Design/Methods This retrospective cohort study at two tertiary hospitals in Thailand compared the efficacy and safety of albumin and FFP as replacement fluids in therapeutic plasma exchange (TPE). Adult patients with NMOSD or MS experiencing steroid-refractory relapses were included. Functional outcomes were assessed using the Expanded Disability Status Scale (EDSS) and Opticospinal Impairment Scale (OSIS) at baseline, post-TPE, and at 90 and 180 days. The primary endpoint was the proportion of patients with a favorable functional outcome (EDSS < 6) at day 180.

Results A total of 67 patients were analyzed, of whom 97% had NMOSD; 41 received albumin and 26 received FFP. By day 180, favorable outcomes were achieved in 75.6% of the albumin group and 73.1% of the FFP group (P = 1.00). Both groups exhibited significant improvement in EDSS and OSIS scores over time. Albumin use was linked to greater motor recovery, while FFP was associated with better visual improvement. Adverse events were mild and comparable between groups.

Conclusions

TPE with either albumin or FFP is effective and safe for managing steroid-refractory NMOSD and MS. Owing to its lower cost and wider availability, FFP serves as a practical alternative to albumin in resource-limited healthcare settings.

Authors/Disclosures
Chutithep Teekaput, MD, PhD PRESENTER	Dr. Teekaput has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Pfizer. Dr. Teekaput has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for BL Hua. The institution of Dr. Teekaput has received research support from Chiang Mai University.
Bhume Kanokvichitra, MD	Mr. Kanokvichitra has nothing to disclose.

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