A randomized trial of plasma exchange in acute central nervous system inflammatory demyelinating disease

Weinshenker, Brian G.; O’Brien, Peter C.; Petterson, Tanya M.; Noseworthy, John H.; Lucchinetti, Claudia F.; Dodick, David W.; Pineda, Alvaro A.; Stevens, Lorna N.; Rodriguez, Moses

doi:10.1002/1531-8249(199912)46:6<878::aid-ana10>3.0.co;2-q

Cited by 824 publications

(523 citation statements)

References 33 publications

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“…The efficacy of TPE for relapsing-remitting MS and other inflammatory demyelinating diseases was demonstrated in a randomized, controlled trial and several uncontrolled studies [36][37][38][39][40]. TPE was also reported to be beneficial for NMOSD attacks [40][41][42][43].…”

Section: Treatment Of Nmosd Attacksmentioning

confidence: 97%

Present and Future Therapies in Neuromyelitis Optica Spectrum Disorders

Kleiter

Gold

2016

Neurotherapeutics

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Neuromyelitis optica spectrum disorders (NMOSD) are important evolving entities, which have reached much attention in the recent years. NMOSD are characterized by inflammatory lesions in the optic nerves, spinal cord, and central parts of the brain, as well as an autoimmune process directed against aquaporin-4. As disability in NMOSD accumulates by inflammatory damage from attacks, both the treatment and prevention of attacks are decisive for the long-term outcome. NMOSD attacks are treated with highdose intravenous corticosteroids and apheresis therapies, in particular therapeutic plasma exchange. In cases of incomplete remission, escalation of attack treatment is recommended. Preventive therapy is immunosuppressive and should by commenced as early as possible. Apart from classical immunosuppressants such as azathioprine and mycophenolate mofetil, repurposed biologicals are increasingly used. B-cell depletion with rituximab and other agents, inhibition of the interleukin-6 receptor with tocilizumab, and blockade of complement-mediated damage by eculizumab all are promising therapeutic strategies evaluated in randomized controlled trials. In this review, we will discuss present and future immunotherapies for NMOSD and also consider combination of treatments, plasma, cellular and other therapies. Current advances in immunopathological knowledge are translated into innovative concepts and begin a new era of NMOSD therapy.

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Section: Treatment Of Nmosd Attacksmentioning

confidence: 97%

Present and Future Therapies in Neuromyelitis Optica Spectrum Disorders

Kleiter

Gold

2016

Neurotherapeutics

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“…Several alternatives, including plasmapheresis [48][49][50][51], cyclophosphamide [48,52,53], intravenous immunoglobulin G (IV-IG) [54][55][56][57][58], and natalizumab [59] have been studied with plasmapheresis as the only option supported by strong clinical evidence. The recent American Academy of Neurology guideline published in January 2011 [60] recommends considering using plasma exchange as a secondary treatment for severe flares in remitting-relapsing MS.…”

Section: Second Line Of Treatment For Ms Relapse Cases Unresponsive Tmentioning

confidence: 99%

Treatment of Acute Relapses in Multiple Sclerosis

Berkovich

2016

Translational Neuroimmunology in Multiple Sclerosis

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“…Lo anterior provoca una destrucción no selectiva de la materia blanca y gris, incluyendo axones y oligodendrocitos . Una localización similar fue encontrada en casos severos de glicoproteína mielínica del oligodendrocito (MOG)-encefalitis autoinmune experimental (EAE); este fenómeno es probablemente debido a la isquemia inducida por el edema (10,11,12,13).…”

Section: Inmunología De La Nmounclassified

Neuromielitis Óptica. Patología, diagnóstico y tratamiento en el siglo XXI

Pinzón¹

2015

Rev. Sal. Bosq

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La neuromielitis óptica (NMO) o enfermedad de Devic, pertenece al grupo de las enfermedades desmielinizantes del sistema nervioso central, afecta de manera significativa los nervios ópticos y la médula espinal. Desde el siglo XIX cuando Eugene Devic dio a conocer una serie de casos en los que existía asociación de lesiones en los nervios ópticos y la medula espinal, la relación de la neuromielitis óptica (NMO) y la Esclerosis Múltiple (EM) ha sido controversial, considerándose una variante de esta última; datos recientes muestran que puede ser distinguida de la Esclerosis Múltiple (EM). Los síntomas de la NMO son por lo general más agudos y severos y la presencia de un autoanticuerpo específico en sangre llamado NMO-IgG tipo acuoporina-4 (AQP4) desempeña un rol muy importante en la patogenia de esta enfermedad,asimismo se encuentran varias características entre ellas de tipo clínico, de laboratorio, neuroimágenes y en la anatomía patológica que diferencian la esclerosis múltiple (EM) de esta enfermedad. La proporción entre mujeres y hombres es mayor de 4 a 1.La presentación clínica y el curso de la enfermedad puede ser con recaídas en 80-90% y en un 10-20% curso monofásico. La manifestación distintiva de la entidad NMO es la ocurrencia ya sea consecutiva o simultánea de NO (unilateral o bilateral) y la presencia de mielitis longitudinal extensa (Mle). La terapia con corticosteroides intravenosos normalmente es el tratamiento Andrés Mauricio Álvarez Pinzón. AbstractOptic Neuromyelitis (NMO) or Devic's disease, is a demyelinating disease of central nervous system, affects the optic nerves and spinal cord. Since the nineteenth century when Eugene Devic unveiled a series of cases in which there was an association of lesions in the optic nerves and spinal cord with relation of NMO and Multiple Sclerosis (MS) has been controversial, in some cases described like a variant of the latter but recent data show that can be distinguished from multiple sclerosis (MS). Symptoms of NMO are usually more acute and severe and then we can find a presence of a specific autoantibody called NMO-IgG, it is a blood type acuoporina-4 (AQP4) and plays an important role in the pathogenesis of this disease. Also in the new millennium are various types of clinical, laboratory, neuroimaging and pathological anatomy then differentiates multiple sclerosis (MS) of this disease. In the epidemiology the ratio of women to men is greater than 4 to 1.The clinical presentation and course of the disease can be relapsing by 80-90% and 10-20% monophasic course. The distinctive manifestation is the occurrence NMO entity either consecutively or simultaneously not (unilateral or bilateral) and the presence of extensive longitudinal myelitis. Intravenous corticosteroid therapy is usually the initial therapy for acute attacks of optic neuritis or myelitis. Plasmapheresis therapy is used when the steroids therapy no work during 1. Artículo de revisión.

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A randomized trial of plasma exchange in acute central nervous system inflammatory demyelinating disease

Cited by 824 publications

References 33 publications

Present and Future Therapies in Neuromyelitis Optica Spectrum Disorders

Present and Future Therapies in Neuromyelitis Optica Spectrum Disorders

Treatment of Acute Relapses in Multiple Sclerosis

Neuromielitis Óptica. Patología, diagnóstico y tratamiento en el siglo XXI

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