Immunoadsorption in steroid-refractory multiple sclerosis

Multiple sclerosis (MS) is an autoimmune disorder, with involvement of both the humoral and cellular components of the immune system. The use of plasma exchange (PE) in steroid-refractory relapses has become an integral part of national and international guidelines for the treatment of steroid-resis...

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Bibliographic Details
Published in:Atherosclerosis. Supplements 2013-01, Vol.14 (1), p.175-178
Main Authors: Koziolek, Michael J., Kitze, Bernd, Mühlhausen, Johannes, Müller, Gerhard A.
Format: Article
Language:English
Subjects:
Absorption
Apheresis
Autoantibodies - blood
Autoimmunity
Biomarkers - blood
Blood Component Removal - adverse effects
Blood Component Removal - methods
Disability Evaluation
Drug Resistance
Humans
Immunoadsorption
Immunosorbent Techniques - adverse effects
Immunosorbents - adverse effects
Immunosorbents - therapeutic use
Multiple sclerosis
Multiple Sclerosis, Relapsing-Remitting - blood
Multiple Sclerosis, Relapsing-Remitting - diagnosis
Multiple Sclerosis, Relapsing-Remitting - immunology
Multiple Sclerosis, Relapsing-Remitting - physiopathology
Multiple Sclerosis, Relapsing-Remitting - therapy
Neuroinflammation
Plasma Exchange
Recovery of Function
Steroids - therapeutic use
Time Factors
Treatment Outcome
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Summary:Multiple sclerosis (MS) is an autoimmune disorder, with involvement of both the humoral and cellular components of the immune system. The use of plasma exchange (PE) in steroid-refractory relapses has become an integral part of national and international guidelines for the treatment of steroid-resistant relapses of MS with an efficacy of 40–70%. So far, 6 studies of immunoadsorption (IA) treatment in different forms of MS have been published, 4 of them in steroid-refractory MS relapses. These 4 studies revealed a significant clinical improvement in 73–85% of patients with steroid-refractory MS relapses. However in MS patients with non-active relapsing–remitting or secondary progressive course, there was no clinical improvement. Despite the limited number of patients and studies, these data suggest a reasonably similar efficacy of IA in the treatment of steroid-refractory MS relapses compared to PE. More prospective trials are needed to confirm and extend these results.
ISSN:1567-5688
1878-5050
DOI:10.1016/j.atherosclerosissup.2012.10.026