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Plasma exchange in acute attacks of demyelinating diseases of the central nervous system: clinical outcomes and predictors of response

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Abstract

Background

Plasma exchange (PLEX) is a therapeutic option in the treatment of acute attacks of Demyelinating Diseases of the Central Nervous System (DDCNS). Factors related with PLEX response are not well established.

Methods

Descriptive and retrospective study. We included patients treated with PLEX for acute attacks of DDCNS between 2008 and 2017. We recorded demographics, clinical and treatment-related data, and Expanded Disability Status Scale (EDSS) score at admission, at discharge, and at 6 months.

Results

We included 64 patients. Forty-eight (75%) were female with a mean age of 48.28 ± 11.5 years. Half of our patients were diagnosed with multiple sclerosis. Clinical improvement was achieved in 51.6% at discharge and 62.5% at 6 months. The logistic regression model showed that EDSS score > 3 at admission (p = 0.04) and early clinical improvement with PLEX (p = 0.00) were predictors of good response to PLEX at discharge and at 6 months, respectively. No serious adverse effects were identified.

Conclusions

PLEX is a safe and effective treatment for acute attacks of DDCNS. EDSS score at admission and early clinical improvement with PLEX were factors associated with good response to PLEX.

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Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

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Authors and Affiliations

  1. Department of Neurology, General University Hospital “Gregorio Marañon”, Madrid, Spain

    Michael A. Palacios-Mendoza, María L. Martínez Ginés, Pedro J. Melgarejo Otálora, Juan P. Cuello, Antonio Sánchez-Soblechero, Alberto Lozano Ros, José A. Aparcero-Suero, Sergio López Anguita & José M. García Domínguez

  2. Department of Nephrology, General University Hospital “Gregorio Marañon”, Madrid, Spain

    Fernando Anaya

Authors
  1. Michael A. Palacios-Mendoza
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  2. María L. Martínez Ginés
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  3. Pedro J. Melgarejo Otálora
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  4. Juan P. Cuello
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  5. Antonio Sánchez-Soblechero
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  6. Alberto Lozano Ros
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  7. José A. Aparcero-Suero
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  8. Sergio López Anguita
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  9. Fernando Anaya
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  10. José M. García Domínguez
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Michael A. Palacios Mendoza, Pedro J. Melgarejo Otálora, Antonio Sánchez-Soblechero, José A. Aparcero-Suero, Sergio López Anguita, and José M. García Domínguez. The first draft of the manuscript was written by Michael A. Palacios Mendoza and José M. García Domínguez, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Michael A. Palacios-Mendoza.

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The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Ethical approval

The study was approved by the Ethic Committee of General University Hospital “Gregorio Marañon”. This is specified in "Methods".

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Palacios-Mendoza, M.A., Martínez Ginés, M.L., Melgarejo Otálora, P.J. et al. Plasma exchange in acute attacks of demyelinating diseases of the central nervous system: clinical outcomes and predictors of response. Neurol Sci 41, 2569–2574 (2020). https://doi.org/10.1007/s10072-020-04382-w

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  • DOI: https://doi.org/10.1007/s10072-020-04382-w

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