The early administration of plasma exchange for the first-line management of acute attacks of neuromyelitis optica spectrum disorders led to better clinical management compared to standard therapy in a retrospective study.
Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune condition that is characterized by the demyelination of the central nervous system. Patients with NMOSD develop myelitis and optic neuritis, which results in impaired quality of life and disability. When patients fail to respond to standard immunosuppressive therapy, plasma exchange can be considered a first-line option for the management of acute attacks.
This retrospective cohort study aimed to assess the efficacy of plasma exchange as a first-line treatment in acute attacks of NMOSD. The study findings are published in the International Journal of Life Sciences, Biotechnology, and Pharma.
Baseline Characteristics
The study included a total of 40 patients who developed acute attacks of NMOSD. The patients were divided into plasma exchange and standard immunosuppressive therapy groups. All patients were aged ≥ 18 years. The plasma exchange group participants were administered treatment within 7 days of the development of symptoms. The treatment protocol comprised five plasma exchanges over a period of 2 weeks, in order to eliminate immune complexes and antibodies. The second group was administered high-dose corticosteroids intravenously as initial therapy, followed by maintenance treatment.
Significant Changes Noted in Expanded Disability Status Scale Scores
In the plasma exchange group, the improvement in Expanded Disability Status Scale (EDSS) scores was significantly greater compared to that of the standard immunosuppressive treatment group (-2.6 ± 0.8 vs -0.9 ± 0.7, respectively).
Plasma Exchange and MRI Findings
The plasma exchange group participants demonstrated a significant reduction in brain and spinal cord lesions, as evident on the magnetic resonance imaging (MRI) after the treatment. Some degree of improvement was also observed among participants in the standard immunosuppression therapy group. Plasma exchange was found to be associated with a reduced lesion burden in the brain and spinal cord
Source:
Kundal BR, R., Pahda K. (2023). Plasma Exchange as a First Line Therapy in Acute Attacks of Neuromyelitis Optica Spectrum Disorders. International Journal of Life Sciences, Biotechnology and Pharma Research 12(4), 376–378.
