BACKGROUND: A marked proportion of multiple sclerosis (MS) relapses is followed by incomplete recovery. Our aim was to considerably increase the evidence of the clinical use of immunoadsorption (IA) as escalation therapy for patients with MS relapse. METHODS: A retrospective multicenter study was performed in MS patients with steroid refractory relapse who were treated with tryptophan IA. The main outcome parameter was change of acute relapse-related disability assessed by Expanded Disability Status Scale (EDSS) and visual acuity (VA) measurements for patients with optic neuritis (ON). IA treatments were performed using single-use tryptophan adsorbers. RESULTS: Data of 147 MS patients and 786 single IA treatments were analyzed. Treatment with IA was commenced in mean 32 ± 35 days after the onset of relapse. One hundred and five out of 147 patients (71.4%) improved functionally after mean 5.4 IA treatments within 7-10 days. EDSS improved from median 5 (interquartile range, IQR 3.5) to 4 (IQR 2.5) (p < 0.001). In patients with ON (n = 32), VA improved after the IA series in 84% of cases from median 0.2 (IQR 0.6) to 0.6 (IQR 0.66) (p < 0.001). In 98.9% of IA treatments, no clinically relevant side effect was reported. CONCLUSION: Tryptophan IA was found to be effective and well tolerated as escalation therapy for MS relapse.
BACKGROUND: A marked proportion of multiple sclerosis (MS) relapses is followed by incomplete recovery. Our aim was to considerably increase the evidence of the clinical use of immunoadsorption (IA) as escalation therapy for patients with MS relapse. METHODS: A retrospective multicenter study was performed in MSpatients with steroid refractory relapse who were treated with tryptophan IA. The main outcome parameter was change of acute relapse-related disability assessed by Expanded Disability Status Scale (EDSS) and visual acuity (VA) measurements for patients with optic neuritis (ON). IA treatments were performed using single-use tryptophan adsorbers. RESULTS: Data of 147 MSpatients and 786 single IA treatments were analyzed. Treatment with IA was commenced in mean 32 ± 35 days after the onset of relapse. One hundred and five out of 147 patients (71.4%) improved functionally after mean 5.4 IA treatments within 7-10 days. EDSS improved from median 5 (interquartile range, IQR 3.5) to 4 (IQR 2.5) (p < 0.001). In patients with ON (n = 32), VA improved after the IA series in 84% of cases from median 0.2 (IQR 0.6) to 0.6 (IQR 0.66) (p < 0.001). In 98.9% of IA treatments, no clinically relevant side effect was reported. CONCLUSION:Tryptophan IA was found to be effective and well tolerated as escalation therapy for MS relapse.
Authors: Leoni Rolfes; Steffen Pfeuffer; Tobias Ruck; Nico Melzer; Marc Pawlitzki; Michael Heming; Marcus Brand; Heinz Wiendl; Sven G Meuth Journal: J Clin Med Date: 2019-10-04 Impact factor: 4.241
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Authors: Frank Hoffmann; Andrea Kraft; Franz Heigl; Erich Mauch; Jürgen Koehler; Lutz Harms; Tania Kümpfel; Wolfgang Köhler; Sven Ehrlich; Antonios Bayas; Julia Weinmann-Menke; Carolin Beuker; Karl-Heinz Henn; Ilya Ayzenberg; Gisa Ellrichmann; Kerstin Hellwig; Reinhard Klingel; Cordula Marie Fassbender; Harald Fritz; Torsten Slowinski; Horst Weihprecht; Marcus Brand; Thomas Stiegler; Jan Galle; Sebastian Schimrigk Journal: Ther Adv Neurol Disord Date: 2018-05-28 Impact factor: 6.570
Authors: Georgina Arrambide; Ellen Iacobaeus; Maria Pia Amato; Tobias Derfuss; Sandra Vukusic; Bernhard Hemmer; Lou Brundin; Mar Tintore Journal: Mult Scler Date: 2020-06-12 Impact factor: 6.312
Authors: Johannes Dorst; Tanja Fangerau; Daniela Taranu; Pia Eichele; Jens Dreyhaupt; Sebastian Michels; Joachim Schuster; Albert C Ludolph; Makbule Senel; Hayrettin Tumani Journal: EClinicalMedicine Date: 2019-11-14