Safety of plasma exchange therapy in patients with myasthenia gravis

被引:33
作者
Ebadi, Hamid [1 ]
Barth, David [2 ]
Bril, Vera [1 ]
机构
[1] Univ Toronto, Univ Hlth Network, Div Neurol, Toronto, ON M5G 2C4, Canada
[2] Univ Toronto, Univ Hlth Network, Dept Lab Med, Div Hematol Pathol, Toronto, ON M5G 2C4, Canada
关键词
immunomodulation; MG; plasma exchange; plasmapheresis; PLEX; treatment; PLASMAPHERESIS; IMMUNOGLOBULIN; MODERATE; UPDATE;
D O I
10.1002/mus.23626
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Introduction: Plasma exchange (PLEX) is effective in myasthenia gravis (MG), but there are concerns about its safety. Methods: We collected data prospectively from 42 patients randomized to PLEX treatment in a comparison study with intravenous immunoglobulin (IVIg). Detailed information on the PLEX treatment methodology and adverse events are reported. Results: Forty of 42 patients completed PLEX. Ninety percent were treated in an outpatient setting. Fifty-five percent had no complications, and 45% had mildmoderate reactions that did not require stopping treatment; the majority were citrate reactions and peripheral vascular issues that were easily treated. Fifty-seven percent of patients responded to treatment, and 83% completed PLEX via peripheral venous access. Two patients had severe adverse events: 1 related and 1 unrelated to PLEX. Comorbid disease and age did not predict reactions. Conclusion: PLEX is safe, effective, and well tolerated in patients with MG. Our results do not raise concerns about the safety of PLEX in patients with moderatesevere MG. Muscle Nerve 47: 510514, 2013
引用
收藏
页码:510 / 514
页数:5
相关论文
共 17 条
[1]   Comparison of IVIg and PLEX in patients with myasthenia gravis [J].
Barth, D. ;
Nouri, M. Nabavi ;
Ng, E. ;
Nwe, P. ;
Bril, V. .
NEUROLOGY, 2011, 76 (23) :2017-2023
[2]   Plasma Exchange in Elderly Patients [J].
Basic-Jukic, Nikolina ;
Brunetta, Bruna ;
Kes, Petar .
THERAPEUTIC APHERESIS AND DIALYSIS, 2010, 14 (02) :161-165
[3]   Evidence-based guideline update: Plasmapheresis in neurologic disorders Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology [J].
Cortese, I. ;
Chaudhry, V. ;
So, Y. T. ;
Cantor, F. ;
Cornblath, D. R. ;
Rae-Grant, A. .
NEUROLOGY, 2011, 76 (03) :294-300
[4]  
Gajdos P, 2002, Cochrane Database Syst Rev, pCD002275, DOI 10.1002/14651858.CD002275
[5]   Predictors of response to immunomodulation in patients with myasthenia gravis [J].
Katzberg, Hans D. ;
Barnett, Carolina ;
Bril, Vera .
MUSCLE & NERVE, 2012, 45 (05) :648-652
[6]   PLASMAPHERESIS WITH IMMUNOSUPPRESSIVE DRUG-THERAPY IN PROGRESSIVE MULTIPLE-SCLEROSIS - A PILOT-STUDY [J].
KHATRI, BO ;
KOETHE, SM ;
MCQUILLEN, MP .
ARCHIVES OF NEUROLOGY, 1984, 41 (07) :734-738
[7]   OUTCOME OF PLASMAPHERESIS IN MYASTHENIA GRAVIS: DELAYED THERAPY IS NOT FAVORABLE [J].
Mandawat, Aditya ;
Mandawat, Anant ;
Kaminski, Henry J. ;
Shaker, Zaid A. ;
Alawi, Aws A. ;
Alshekhlee, Amer .
MUSCLE & NERVE, 2011, 43 (04) :578-584
[8]   Comparative Analysis of Therapeutic Options Used for Myasthenia Gravis [J].
Mandawat, Aditya ;
Kaminski, Henry J. ;
Cutter, Gary ;
Katirji, Bashar ;
Alshekhlee, Amer .
ANNALS OF NEUROLOGY, 2010, 68 (06) :797-805
[9]   Therapeutic apheresis in Sweden: update of epidemiology and adverse events [J].
Norda, R ;
Stegmayr, BG .
TRANSFUSION AND APHERESIS SCIENCE, 2003, 29 (02) :159-166
[10]  
PINCHING AJ, 1976, LANCET, V2, P1373