Kleiter, Ingo and Gahlen, Anna and Borisow, Nadja and Fischer, Katrin and Wernecke, Klaus-Dieter and Hellwig, Kerstin and Pache, Florence and Ruprecht, Klemens and Havla, Joachim and Kumpfel, Tania and Aktas, Orhan and Hartung, Hans-Peter and Ringelstein, Marius and Geis, Christian and Kleinschnitz, Christoph and Berthele, Achim and Hemmer, Bernhard and Angstwurm, Klemens and Stellmann, Jan-Patrick and Schuster, Simon and Stangel, Martin and Lauda, Florian and Tumani, Hayrettin and Mayer, Christoph and Krumbholz, Markus and Zeltner, Lena and Ziemann, Ulf and Linker, Ralf and Schwab, Matthias and Marziniak, Martin and Bergh, Florian Then and Hofstadt-van Oy, Ulrich and Neuhaus, Oliver and Zettl, Uwe K. and Faiss, Juergen and Wildemann, Brigitte and Paul, Friedemann and Jarius, Sven and Trebst, Corinna (2018) Apheresis therapies for NMOSD attacks A retrospective study of 207 therapeutic interventions. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION, 5 (6): e504. ISSN 2332-7812,
Full text not available from this repository. (Request a copy)Abstract
Objective To analyze whether 1 of the 2 apheresis techniques, therapeutic plasma exchange (PE) or immunoadsorption (IA), is superior in treating neuromyelitis optica spectrum disorder (NMOSD) attacks and to identify predictive factors for complete remission (CR). Methods This retrospective cohort study was based on the registry of the German Neuromyelitis Optica Study Group, a nationwide network established in 2008. It recruited patients with neuromyelitis optica diagnosed according to the 2006 Wingerchuk criteria or with aquaporin-4 (AQP4-ab)-antibody-seropositive NMOSD treated at 6 regional hospitals and 16 tertiary referral centers until March 2013. Besides descriptive data analysis of patient and attack characteristics, generalized estimation equation (GEE) analyses were applied to compare the effectiveness of the 2 apheresis techniques. A GEE model was generated to assess predictors of outcome. Results Two hundred and seven attacks in 105 patients (87% AQP4-ab-antibody seropositive) were treated with at least 1 apheresis therapy. Neither PE nor IA was proven superior in the therapy of NMOSD attacks. CR was only achieved with early apheresis therapy. Strong predictors for CR were the use of apheresis therapy as first-line therapy (OR 12.27, 95% CI: 1.04-144.91, p = 0.047), time from onset of attack to start of therapy in days (OR 0.94, 95% CI: 0.89-0.99, p = 0.014), the presence of AQP4-abantibodies (OR 33.34, 95% CI: 1.76-631.17, p = 0.019), and monofocal attack manifestation (OR 4.71, 95% CI: 1.03-21.62, p = 0.046). Conclusions Our findings suggest early use of an apheresis therapy in NMOSD attacks, particularly in AQP4-ab-seropositive patients. No superiority was shown for one of the 2 apheresis techniques.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | PLASMA-EXCHANGE; NEUROMYELITIS-OPTICA; DILATED CARDIOMYOPATHY; CNS DEMYELINATION; SPECTRUM; IMMUNOADSORPTION; EFFICACY; PLASMAPHERESIS; IMPROVEMENT; PREDICTORS; |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Neurologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 10 Oct 2019 07:17 |
| Last Modified: | 10 Oct 2019 07:17 |
| URI: | https://pred.uni-regensburg.de/id/eprint/13574 |
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