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Therapeutic apheresis within immune-mediated neurological disorders: dosing and its effectiveness
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Therapeutic apheresis within immune-mediated neurological disorders: dosing and its effectiveness
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Journal Article
Therapeutic apheresis within immune-mediated neurological disorders: dosing and its effectiveness
2020
Overview
Plasma exchange (PE) and immunoadsorption (IA) are standard therapeutic options of immune-mediated neurological disorders. This study evaluates the relation of the relative quantity of applied dose of PE and/ or IA and its achieved therapeutic effectiveness within the treated underlying neurological disorders. In a retrospective study, we evaluated data from PE and IA carried out 09/2009-06/2014 in neurological patients at the University-Hospital of Saarland, Germany. Apheresis dose was defined as the ratio of the extracorporeal treated plasma volume to the patient’s plasma volume. Effectiveness was assessed through disease-specific tests and scores by the attending neurologist(s); results were classified into response or no response. 1101 apheresis (PE:238, IA:863), in 153 hospital-stays were carried out, averaged, 7.0 treatments per patients, 82% responded, 18% not. Mean applied apheresis dose per treatment was 0.91 with mean doses of 1.16 for PE and 0.81 for IA. The totally applied mean dose per stay was 5.6 (PE:5.01, IA:5.81). No correlation was seen between apheresis dosing and treatment effectiveness (PE:R2 = 0.074, IA:R2 = 0.0023). PE and IA in therapy-refractory immune-mediated neurological disorders majorly achieved a measurable severity improvement – without correlation to the applied dose. Moreover, our data rather suggest, that effectiveness may be given with volumes below currently recommended volumes.
Publisher
Nature Publishing Group UK,Nature Publishing Group
Subject
/ Adult
/ Aged
/ Anticoagulants - administration & dosage
/ Anticoagulants - adverse effects
/ Anticoagulants - therapeutic use
/ Blood Component Removal - adverse effects
/ Blood Component Removal - methods
/ Dosage
/ Female
/ Humanities and Social Sciences
/ Humans
/ Male
/ Nervous System Diseases - diagnosis
/ Nervous System Diseases - epidemiology
/ Nervous System Diseases - immunology
/ Nervous System Diseases - therapy
/ Patients
/ Science
