期刊
JOURNAL OF CLINICAL MEDICINE
卷 8, 期 10, 页码 -出版社
MDPI
DOI: 10.3390/jcm8101623
关键词
immunoadsorption; acute relapsing multiple sclerosis; plasma exchange; therapeutic apheresis
资金
- Merck Serono
- Diamed
- German Multiple Sclerosis Society
- Genzyme
- Novartis
- Euroimmun
- Fresenius Medical Care
- Alexion Pharmaceuticals
- Novartis Pharma
- Bayer
- Biogen
- Sanofi Genzyme
- Sanofi US
- Teva
- German Ministry for Education and Research (BMBF)
- Deutsche Forschungsgemeinschaft (DFG)
- Else Kroner Fresenius Foundation
- German Academic Exchange Service
- Hertie Foundation
- Interdisciplinary Center for Clinical Studies (IZKF) Muenster
- German Foundation Neurology and Almirall
- Amicus Therapeutics Germany
- ONO Pharma
- Roche
Multiple sclerosis (MS) is the most abundant inflammatory demyelinating disorder of the central nervous system. Despite recent advances in its long-term immunomodulatory treatment, MS patients still suffer from relapses, significantly contributing to disability accrual. In recent years, apheresis procedures such as therapeutic plasma exchange (TPE) and immunoadsorption (IA) have been recognized as two options for treating MS relapses, that do not respond to standard treatment with corticosteroids. TPE is already incorporated in most international guidelines, although evidence for its use resulted mostly from either case series or small unblinded and/or non-randomized trials. Data on IA are still sparse, but several studies indicate comparable efficacy between both apheresis procedures. This article gives an overview of the published evidence on TPE and IA in the treatment of acute relapses in MS. Further, we outline current evidence regarding individual outcome predictors, describe technical details of apheresis procedures, and discuss apheresis treatment in children and during pregnancy.
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