OBJECTIVES: The goal of this study was to analyze safety and assess the efficacy of standard plasma exchange (PE) compared with immunoadsorption (IA) alone, or an alternating combination of both in deteriorating myasthenia gravis (MG). METHODS: A total of 72 patients with MG who had received PE procedures for treatment of severe deterioration were retrospectively analyzed. They received either five cycles of PE (1-1.5 plasma volumes), or five cycles of IA in line with plasma separation, or a sequential alternating procedure of one cycle of PE followed by two cycles of IA, which was repeated once or more if needed. RESULTS: A total of 19 patients received PE, 24 patients IA, and 29 the alternating combination therapy. All groups were equally distributed by sex and mean MG score before treatment. The number of treatment cycles and days on therapy did not differ between the groups. Mean MG scores at discharge were 3.0 (PE), 1.8 (IA) and 1.6 (combination) (p = 0.028 for combination versus PE). Inpatient time was 30.7 days (PE), 22.3 days (IA) and 20.0 days in combination therapy (p < 0.05 for combination versus PE). Side effects such as allergic reactions or hypocoagulability were significantly more frequent in the PE group (37% in PE versus 4% in IA and 3.6% in the alternating combination, p < 0.05). CONCLUSION: Semiselective IA in combination with PE, and to a lesser extent IA alone, was associated with a shorter hospital stay and more pronounced reduction of the MG score than PE.
OBJECTIVES: The goal of this study was to analyze safety and assess the efficacy of standard plasma exchange (PE) compared with immunoadsorption (IA) alone, or an alternating combination of both in deteriorating myasthenia gravis (MG). METHODS: A total of 72 patients with MG who had received PE procedures for treatment of severe deterioration were retrospectively analyzed. They received either five cycles of PE (1-1.5 plasma volumes), or five cycles of IA in line with plasma separation, or a sequential alternating procedure of one cycle of PE followed by two cycles of IA, which was repeated once or more if needed. RESULTS: A total of 19 patients received PE, 24 patients IA, and 29 the alternating combination therapy. All groups were equally distributed by sex and mean MG score before treatment. The number of treatment cycles and days on therapy did not differ between the groups. Mean MG scores at discharge were 3.0 (PE), 1.8 (IA) and 1.6 (combination) (p = 0.028 for combination versus PE). Inpatient time was 30.7 days (PE), 22.3 days (IA) and 20.0 days in combination therapy (p < 0.05 for combination versus PE). Side effects such as allergic reactions or hypocoagulability were significantly more frequent in the PE group (37% in PE versus 4% in IA and 3.6% in the alternating combination, p < 0.05). CONCLUSION: Semiselective IA in combination with PE, and to a lesser extent IA alone, was associated with a shorter hospital stay and more pronounced reduction of the MG score than PE.
Authors: Andreas Totzeck; Michael Jahn; Benjamin Stolte; Andreas Thimm; Christoph Kleinschnitz; Tim Hagenacker Journal: J Clin Med Date: 2022-07-28 Impact factor: 4.964
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: 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