Contributions
Abstract: EP1297
Type: ePoster
Abstract Category: Clinical aspects of MS - 2 MS Variants
Background: Therapeutic plasma exchange (TPE) is performed for the treatment of severe neuromyelitis optica spectrum disorders (NMOSD) relapses, but the efficacy of maintenance TPE (mTPE) in NMOSD has been underreported so far.
Material and methods: Eighteen NMOSD patients (15 female, 3 male; median age, 46.3 years), were treated with mTPE, once monthly. In the group A (n=9), mTPE was initiated after the treatment of severe relapse and performed until the maximal neurological recovery was achieved. In the group B (n= 9), mTPE was used as an add-on therapy to steroids and/or classical immunosuppressants, in cases of disease activity in spite of the optimal treatment (4 patients), or in addition to steroids in patients with a poor compliance, intolerance or contraindications for immunosuppressive therapy (5 patients). The Expanded Disability Status Scale (EDSS), including total EDSS score and functional systems scores, were used to assess the level of neurological disability before and after mTPE treatment. Annual relapse rate was used as a clinical disease activity marker.
Results: Median duration of mTPE treatment in the overall group of patients was 1.15 years (range 2.4 months-3.8 years). The EDSS score after the last mTPE procedure was significantly lower than before the first mTPE in the total group of patients (p< 0.001), and also in the group A (p< 0.05), while the EDSS score in the group B was unchanged during mTPE. The statistically significant improvements after mTPE were observed in pyramidal, sensory and bowel/bladder scores. The average annual relapse rate was significantly lower during mTPE than before mTPE initiation in the total patient group (p< 0.001), as well as in both subgroups A (p< 0.01) and B (p< 0.05).
Conclusion: Our results show that the use of mTPE as an add-on therapy is associated with the reduction of disease activity and/or with neurological improvement in patients with NMOSD.
Disclosure:
Irena Dujmović Bašuroski received lecture fees and/or travel grants from Merck Serono, Bayer, Medis, Roche, Teva and Boehringer Ingelheim, received honoraria for acting as an advisor for Bayer and was supported by the Ministry of Education, Science and Technological Development of the Republic of Serbia (Grant No 175031).
Vanja Martinović has nothing to disclose.
Jovana Ivanović has nothing to disclose.
Tamara Žegarac has nothing to disclose.
Marko Andabaka has nothing to disclose.
Sarlota Mesaros received speaker´s honoraria for Merck Serono and Novartis, travel grants from Bayer, Medis and Genzyme, a Sanofi Company, and was supported by the Ministry of Education, Science and Technological Development of the Republic of Serbia (Grant No 175031).
J Drulovic serves on scientific advisory boards for Bayer Schering Pharma, Merck Serono, Teva, Genzyme, a Sanofi Company, Roche, and received honoraria for speaking from Merck Serono, Teva, Bayer Schering, Genzyme, a Sanofi Company, Medis; and has also received research grant support from the Ministry of Education and Science, Republic of Serbia (project no. 175031).
Abstract: EP1297
Type: ePoster
Abstract Category: Clinical aspects of MS - 2 MS Variants
Background: Therapeutic plasma exchange (TPE) is performed for the treatment of severe neuromyelitis optica spectrum disorders (NMOSD) relapses, but the efficacy of maintenance TPE (mTPE) in NMOSD has been underreported so far.
Material and methods: Eighteen NMOSD patients (15 female, 3 male; median age, 46.3 years), were treated with mTPE, once monthly. In the group A (n=9), mTPE was initiated after the treatment of severe relapse and performed until the maximal neurological recovery was achieved. In the group B (n= 9), mTPE was used as an add-on therapy to steroids and/or classical immunosuppressants, in cases of disease activity in spite of the optimal treatment (4 patients), or in addition to steroids in patients with a poor compliance, intolerance or contraindications for immunosuppressive therapy (5 patients). The Expanded Disability Status Scale (EDSS), including total EDSS score and functional systems scores, were used to assess the level of neurological disability before and after mTPE treatment. Annual relapse rate was used as a clinical disease activity marker.
Results: Median duration of mTPE treatment in the overall group of patients was 1.15 years (range 2.4 months-3.8 years). The EDSS score after the last mTPE procedure was significantly lower than before the first mTPE in the total group of patients (p< 0.001), and also in the group A (p< 0.05), while the EDSS score in the group B was unchanged during mTPE. The statistically significant improvements after mTPE were observed in pyramidal, sensory and bowel/bladder scores. The average annual relapse rate was significantly lower during mTPE than before mTPE initiation in the total patient group (p< 0.001), as well as in both subgroups A (p< 0.01) and B (p< 0.05).
Conclusion: Our results show that the use of mTPE as an add-on therapy is associated with the reduction of disease activity and/or with neurological improvement in patients with NMOSD.
Disclosure:
Irena Dujmović Bašuroski received lecture fees and/or travel grants from Merck Serono, Bayer, Medis, Roche, Teva and Boehringer Ingelheim, received honoraria for acting as an advisor for Bayer and was supported by the Ministry of Education, Science and Technological Development of the Republic of Serbia (Grant No 175031).
Vanja Martinović has nothing to disclose.
Jovana Ivanović has nothing to disclose.
Tamara Žegarac has nothing to disclose.
Marko Andabaka has nothing to disclose.
Sarlota Mesaros received speaker´s honoraria for Merck Serono and Novartis, travel grants from Bayer, Medis and Genzyme, a Sanofi Company, and was supported by the Ministry of Education, Science and Technological Development of the Republic of Serbia (Grant No 175031).
J Drulovic serves on scientific advisory boards for Bayer Schering Pharma, Merck Serono, Teva, Genzyme, a Sanofi Company, Roche, and received honoraria for speaking from Merck Serono, Teva, Bayer Schering, Genzyme, a Sanofi Company, Medis; and has also received research grant support from the Ministry of Education and Science, Republic of Serbia (project no. 175031).