Contributions
Abstract: EP1480
Type: ePoster
Abstract Category: Therapy - disease modifying - Immunomodulation/Immunosuppression
Introduction: Relapses in Multiple Sclerosis (MS) are often associated with significant disability impairment and often are unresponsive to corticosteroids. In such severe cases, plasma exchange (PLEX) may be used, although only a few studies with small cohorts have been reported.
Objective: Evaluation of effectiveness of PLEX in severe relapses of MS.
Methods: Retrospective study of MS patients treated with PLEX in acute relapses. Data regarding EDSS, annualized relapse rate (ARR), treatment with corticosteroids, number of PLEX sessions, adverse events, and gadolinium enhancement in brain MRI were analysed.
Results: Included 46 patients, 76.1% female (n=35) with mean age of 38.8 years and mean disease duration of 6.0 years, of which 84.8% had a Relapsing Remitting MS (n=39), 15.2% Secondary Progressive MS (n=7). The previous ARR was 1.1 and in 28.3% of the cases (n=13) PLEX was used in the relapse that led to MS diagnosis. The majority of relapses had motor impairment (69.6%, n=32), with a mean EDSS increase of 2.0 point from baseline (maximum of 6.5) and higher than 1.5 points in 45.7% of cases (n=21). Brain MRI was available in 69.6% of the cases (n=32), and gadolinium enhancing lesions were present in 68.8% of cases (n=22). Corticosteroids were used before PLEX in 93.5% of patients (n=43) for a mean of 6.3 days, without any immediate benefit in 37.0% of cases (n=17), with the remaining cases showing only mild disability recovery. After a mean of 7.8 PLEX sessions, there was complete EDSS recovery in 41.3% of patients (n=19), and partial in 39.1% (n=18). There were no adverse events related to PLEX in 89.1% of patients (n=41) and in the remaining patients the reported adverse events included deep venous thrombosis (n=1), anemia (n=1), fever (n=1), hypoalbuminemia (n=1) and arterial hypotension (n=1).
Conclusion: Our results support the use of PLEX in severe relapses unresponsive to corticosteroids, since it was an effective and relatively safe treatment for most of our patients.
Disclosure:
Dr. Inês Correia: nothing to disclose.
Dr. Joana Jesus Ribeiro: nothing to disclose.
Dr. Ana Novo: nothing to disclose.
Dr. Luís Isidoro: nothing to disclose.
Dr. Sónia Batista has received grant support from Biogen and speakers ́ bureau fees from Biogen, Novartis and Merck.
Dr. Carla Nunes has received speakers ́ bureau fees and have been advisory board member for Biogen, Novartis, Teva, Bayer, Genzyme and Merck.
Dr. Carmo Macário has received speakers ́ bureau fees and have been advisory board member for Biogen, Novartis, Teva, Bayer, Genzyme and Merck.
Prof. Luís Cunha: nothing to disclose.
Dr. Jorge Tomás: nothing to disclose.
Dr. Lívia Sousa has received speakers ́ bureau fees and have been advisory board member for Biogen, Novartis, Teva, Bayer, Genzyme and Merck.
Abstract: EP1480
Type: ePoster
Abstract Category: Therapy - disease modifying - Immunomodulation/Immunosuppression
Introduction: Relapses in Multiple Sclerosis (MS) are often associated with significant disability impairment and often are unresponsive to corticosteroids. In such severe cases, plasma exchange (PLEX) may be used, although only a few studies with small cohorts have been reported.
Objective: Evaluation of effectiveness of PLEX in severe relapses of MS.
Methods: Retrospective study of MS patients treated with PLEX in acute relapses. Data regarding EDSS, annualized relapse rate (ARR), treatment with corticosteroids, number of PLEX sessions, adverse events, and gadolinium enhancement in brain MRI were analysed.
Results: Included 46 patients, 76.1% female (n=35) with mean age of 38.8 years and mean disease duration of 6.0 years, of which 84.8% had a Relapsing Remitting MS (n=39), 15.2% Secondary Progressive MS (n=7). The previous ARR was 1.1 and in 28.3% of the cases (n=13) PLEX was used in the relapse that led to MS diagnosis. The majority of relapses had motor impairment (69.6%, n=32), with a mean EDSS increase of 2.0 point from baseline (maximum of 6.5) and higher than 1.5 points in 45.7% of cases (n=21). Brain MRI was available in 69.6% of the cases (n=32), and gadolinium enhancing lesions were present in 68.8% of cases (n=22). Corticosteroids were used before PLEX in 93.5% of patients (n=43) for a mean of 6.3 days, without any immediate benefit in 37.0% of cases (n=17), with the remaining cases showing only mild disability recovery. After a mean of 7.8 PLEX sessions, there was complete EDSS recovery in 41.3% of patients (n=19), and partial in 39.1% (n=18). There were no adverse events related to PLEX in 89.1% of patients (n=41) and in the remaining patients the reported adverse events included deep venous thrombosis (n=1), anemia (n=1), fever (n=1), hypoalbuminemia (n=1) and arterial hypotension (n=1).
Conclusion: Our results support the use of PLEX in severe relapses unresponsive to corticosteroids, since it was an effective and relatively safe treatment for most of our patients.
Disclosure:
Dr. Inês Correia: nothing to disclose.
Dr. Joana Jesus Ribeiro: nothing to disclose.
Dr. Ana Novo: nothing to disclose.
Dr. Luís Isidoro: nothing to disclose.
Dr. Sónia Batista has received grant support from Biogen and speakers ́ bureau fees from Biogen, Novartis and Merck.
Dr. Carla Nunes has received speakers ́ bureau fees and have been advisory board member for Biogen, Novartis, Teva, Bayer, Genzyme and Merck.
Dr. Carmo Macário has received speakers ́ bureau fees and have been advisory board member for Biogen, Novartis, Teva, Bayer, Genzyme and Merck.
Prof. Luís Cunha: nothing to disclose.
Dr. Jorge Tomás: nothing to disclose.
Dr. Lívia Sousa has received speakers ́ bureau fees and have been advisory board member for Biogen, Novartis, Teva, Bayer, Genzyme and Merck.