Échanges plasmatiques dans les maladies inflammatoires démyélinisantes aiguës sévères du système nerveux central

Brunot, S.; Vukusic, Sandra; Fromont, Agnès; Couvreur, G.; Mousson, Christiane; Giroud, M.; Confavreux, Christian; Moreau, Thibault

doi:10.1016/j.lpm.2010.11.022

Cited by 7 publications

(5 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…TPE is an extracorporeal blood purification technique separating plasma from blood and involves the removal of patient plasma and the replacement with another fluid. TPE treatment of isolated ON, acute RRMS, and CIS, refractory to conventional pulsed IVMPS, has been evaluated in several studies [19,33,34,35,36,37,38,39,40,41,42]. Unfortunately, studies assessing functional outcomes of apheresis treatment used different outcome measures, usually referring to either the EDSS or its FSS.…”

Section: Resultsmentioning

confidence: 99%

Therapeutic Apheresis in Acute Relapsing Multiple Sclerosis: Current Evidence and Unmet Needs—A Systematic Review

Rolfes

Pfeuffer

Ruck

et al. 2019

JCM

View full text Add to dashboard Cite

Multiple sclerosis (MS) is the most abundant inflammatory demyelinating disorder of the central nervous system. Despite recent advances in its long-term immunomodulatory treatment, MS patients still suffer from relapses, significantly contributing to disability accrual. In recent years, apheresis procedures such as therapeutic plasma exchange (TPE) and immunoadsorption (IA) have been recognized as two options for treating MS relapses, that do not respond to standard treatment with corticosteroids. TPE is already incorporated in most international guidelines, although evidence for its use resulted mostly from either case series or small unblinded and/or non-randomized trials. Data on IA are still sparse, but several studies indicate comparable efficacy between both apheresis procedures. This article gives an overview of the published evidence on TPE and IA in the treatment of acute relapses in MS. Further, we outline current evidence regarding individual outcome predictors, describe technical details of apheresis procedures, and discuss apheresis treatment in children and during pregnancy.

show abstract

Section: Resultsmentioning

confidence: 99%

Therapeutic Apheresis in Acute Relapsing Multiple Sclerosis: Current Evidence and Unmet Needs—A Systematic Review

Rolfes

Pfeuffer

Ruck

et al. 2019

JCM

View full text Add to dashboard Cite

show abstract

“…74 A further retrospective review of 35 adult patients, concluded that 77% of steroid-resistant patients were improved after treatment with PE. 75 Successful use of PE was also described in some case reports including pediatric cases as well. [76][77][78][79] Moreover, a retrospective analysis of acute demyelinating disorders in children (10 steroid-resistant patients with acute relapses of multiple sclerosis, neuromyelitis optica and ADEM) evaluated the efficacy of PE.…”

Section: Immunotherapeutic Approaches Of Chorea As Manifestation Of Omentioning

confidence: 91%

The usefulness of immunotherapy in pediatric neurodegenerative disorders: A systematic review of literature data

Vitaliti

Tabatabaie

Matin

et al. 2015

Human Vaccines & Immunotherapeutics

View full text Add to dashboard Cite

“…3 6 16 38 39 40 Some predictors were not always found in every study, such as the male sex, retained reflexes, 16 gadolinium-enhancing lesions on magnetic resonance imaging (MRI), and short disease duration, 39 and some predictors were a consistent finding in different studies, such as the early initiation of PLEX, as aforementioned. 3 4 16 27 29 33 36 40 44 45…”

Section: Final Remarksmentioning

confidence: 99%

“…16 A shorter PLEX delay was defined as a predictor of a good outcome in multiple studies, with strong evidence in several CNS-IDD series. 3,16,18,33,36,37,40,[45][46][47] Early initiation of PLEX should be considered in the clinical practice, given that it is a variable that can be controlled to a certain extent if there is access to treatment.…”

Section: The Time Between the Onset Of An Attack And The Initiation O...mentioning

confidence: 99%

“…3,6,16,38-40 Some predictors were not always found in every study, such as the male sex, retained reflexes, 16 gadolinium-enhancing lesions on magnetic resonance imaging (MRI), and short disease duration, 39 and some predictors were a consistent finding in different studies, such as the early initiation of PLEX, as aforementioned. 3,4,16,27,29,33,36,40,44,45 Although initiating PLEX as early as possible seems effective, especially in the treatment of acute NMO relapses, from a practical and realistic point of view, it may be difficult to bypass steroids as the first-line therapy, especially in underdeveloped countries.…”

Section: Final Remarksmentioning

confidence: 99%

See 1 more Smart Citation

Plasma exchange in inflammatory demyelinating disorders of the central nervous system: reasonable use in the clinical practice

et al. 2023

View full text Add to dashboard Cite

Plasma exchange (PLEX) is a therapeutic apheresis modality in which the plasma is separated from inflammatory factors such as circulating autoreactive immunoglobulins, the complement system, and cytokines, and its therapeutic effect is based on the removal of these mediators of pathological processes. Plasma exchange is well established for various neurological disorders, and it is applied successfully in central nervous system inflammatory demyelinating diseases (CNS-IDD). It mainly modulates the humoral immune system; thus, it has a greater theoretical effect in diseases with prominent humoral mechanisms, such as neuromyelitis optica (NMO). However, it also has a proven therapeutic effect in multiple sclerosis (MS) attacks. Several studies have suggested that patients with severe attacks of CNS-IDD have poor response to steroid therapy but show clinical improvement after the PLEX treatment. Currently, PLEX is generally established only as a rescue therapy for steroid unresponsive relapses. However, there are still research gaps in the literature regarding plasma volume, number of sessions, and how early the apheresis treatment needs to started. Thus, in the present article, we summarize the clinical studies and meta-analyses, especially about MS and NMO, outlining clinical data regarding the experience with therapeutic PLEX in severe attacks of CNS-IDD, the clinical improvement rates, the prognostic factors of a favorable response, and highlighting the likely role of the early apheresis treatment. Further, we have gathered this evidence and suggested a protocol for the treatment of CNS-IDD with PLEX in the routine clinical practice.

show abstract

Échanges plasmatiques dans les maladies inflammatoires démyélinisantes aiguës sévères du système nerveux central

Cited by 7 publications

References 27 publications

Therapeutic Apheresis in Acute Relapsing Multiple Sclerosis: Current Evidence and Unmet Needs—A Systematic Review

Therapeutic Apheresis in Acute Relapsing Multiple Sclerosis: Current Evidence and Unmet Needs—A Systematic Review

The usefulness of immunotherapy in pediatric neurodegenerative disorders: A systematic review of literature data

Plasma exchange in inflammatory demyelinating disorders of the central nervous system: reasonable use in the clinical practice

Contact Info

Product

Resources

About