Plasmapherese in der Eskalationstherapie der Multiplen Sklerose: Verlaufsbeobachtung an 35 Patienten

Therapeutic plasma exchange (PE) is established as an escalation therapy for steroid-unresponsive multiple sclerosis (MS) relapses. However, there are only few data on predictors of therapeutic response or long-term efficacy including follow-up therapies. Here, our clinical experience with 35 PE-treated patients and follow-up investigations in 21 patients 6 to 12 months after PE will be summarised. Our data confirm the efficacy of PE in MS relapses with functionally relevant improvement in 71 % of patients, corroborated by electrophysiology in 49 % of them. The mean onset of clinical improvement was again determined after the third exchange while some patients may still improve even as late as after the sixth PE. At the time of the follow-up examination, we found a sustained amelioration of the initial symptom in 71 % of patients. One patient with recurrent episodes of steroid unresponsive optic neuritis and severe side effects during 2 therapeutically successful cycles of PE was effectively and safely treated with immunoadsorption therapy.