Comparison of efficacy of plasma exchange versus intravenous immunoglobulin as an add‐on therapy in acute attacks of neuromyelitis optica spectrum disorder

Author:

Siwach Garima1,Hans Rekha1ORCID,Takkar Aastha2,Ahuja Chirag Kamal3,Lamba Divjot Singh1ORCID,Lal Vivek2,Sharma Ratti Ram1

Affiliation:

1. Department of Transfusion Medicine Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh India

2. Department of Neurology Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh India

3. Department of Radiodiagnosis and Imaging Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh India

Abstract

AbstractIntroductionPlasma exchange (PE) is considered a Category II option for the treatment of acute attacks and relapse cases of neuromyelitis optica spectrum disorder (NMOSD). However, neurologists are also considering intravenous immunoglobulins (IVIg) as an add‐on therapy for this disorder.AimsThe aim of this study is to evaluate the efficacy of PE in acute attacks of NMOSD when compared with IVIg, in terms of improvement in the Expanded disability status scale (EDSS) and activities of daily living (ADL) scale score and levels of anti‐Aquaporin P4 (AQP4) antibody in seropositive patients.MethodsWe enrolled 43 NMOSD patients in two groups: Group 1 (n = 29) received steroids and PE, and Group 2 (n = 14) received steroids with IVIg. The baseline EDSS and ADL scores were recorded and compared with scores at the end of therapy, 4 weeks, and 3 months after. Also, anti‐AQP4 antibody was measured at baseline and post‐therapy in seropositive patients of both groups.ResultsWe observed a significant difference in EDSS (p = 0.00) and ADL score (p = 0.00) at day 10 and 3 months in both groups. However, no significant difference in EDSS, as well as ADL score from baseline (p = 0.83; p = 0.25) to 3 months (p = 0.85; p = 0.19), was observed when delta change of score at 3 months was compared across the two groups (p = 0.39; p = 0.52). We observed improved visual acuity in both groups with mild improvement in findings of magnetic resonance imaging at 3 months. We observed a significant decline in AQP4 antibody concentration (at day 10) in group 1 seropositive patients (p = 0.013) with improved EDSS (p = 0.027) and ADL scores (p = 0.026) of these patients.ConclusionsPE should be considered as a choice of an add‐on therapy in anti‐AQP4 antibody‐positive NMOSD patients compared with IVIg as it is more effective in reducing antibody concentrations.

Publisher

Wiley

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3