Plasma exchange in acute attacks of demyelinating diseases of the central nervous system: clinical outcomes and predictors of response

Neurol Sci. 2020 Sep;41(9):2569-2574. doi: 10.1007/s10072-020-04382-w. Epub 2020 Apr 4.

Abstract

Background: Plasma exchange (PLEX) is a therapeutic option in the treatment of acute attacks of Demyelinating Diseases of the Central Nervous System (DDCNS). Factors related with PLEX response are not well established.

Methods: Descriptive and retrospective study. We included patients treated with PLEX for acute attacks of DDCNS between 2008 and 2017. We recorded demographics, clinical and treatment-related data, and Expanded Disability Status Scale (EDSS) score at admission, at discharge, and at 6 months.

Results: We included 64 patients. Forty-eight (75%) were female with a mean age of 48.28 ± 11.5 years. Half of our patients were diagnosed with multiple sclerosis. Clinical improvement was achieved in 51.6% at discharge and 62.5% at 6 months. The logistic regression model showed that EDSS score > 3 at admission (p = 0.04) and early clinical improvement with PLEX (p = 0.00) were predictors of good response to PLEX at discharge and at 6 months, respectively. No serious adverse effects were identified.

Conclusions: PLEX is a safe and effective treatment for acute attacks of DDCNS. EDSS score at admission and early clinical improvement with PLEX were factors associated with good response to PLEX.

Keywords: Demyelinating diseases; Plasma exchange; Prognosis.

MeSH terms

  • Adult
  • Central Nervous System
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multiple Sclerosis* / therapy
  • Neuromyelitis Optica* / therapy
  • Plasma Exchange
  • Retrospective Studies