治疗性血浆置换治疗视神经脊髓炎谱系疾病患者的视神经炎发作。
Therapeutic plasma exchange for optic neuritis attacks in patients with neuromyelitis optica spectrum disorders.
机构信息
Department of Internal Medicine, Nephrology Unit, Neurology Unit, Hospital Universitario San Ignacio, Bogota, Colombia.
Nephrology, Neurology, Clínica Universitaria Colombia, Bogota, Colombia.
出版信息
Ther Apher Dial. 2022 Dec;26(6):1274-1280. doi: 10.1111/1744-9987.13844. Epub 2022 Apr 7.
BACKGROUND
Optic neuritis (ON) causes several sequela. Aggressive treatment with plasma exchange (TPE) is an option. This study describes improvement and safety outcomes with TPE.
METHODS
We recruited adults with ON in neuromyelitis optica spectrum disorders (NMOSD) patients treated with TPE. The primary outcome was an improvement in the visual acuity scale (VOS). We described the data and used multivariate logistic regression to identify factors associated with response.
RESULTS
Eighty-three patients received 558 TPE sessions. Mean age was 40.9 years (±13.7 years); 73.5% were women, 50.1% were first attack, and 10.7% were bilateral. Median VOS: 5 (range [R], 2-7). Median time between onset and TPE was 8 days (R, 1-32). By Keegan's criteria, 82.4% experience improvement and 78.3% improve in at least 1 point in VOS. Age and pre-TPE VOS were related to improvement. Low fibrinogen occurs in 26% sessions.
CONCLUSION
TPE is effective and safety for ON in NMOSD patients. There is a need for a clinical trial using a therapeutic equivalent.
背景
视神经炎 (ON) 会导致多种后遗症。采用血浆置换 (TPE) 进行积极治疗是一种选择。本研究描述了 TPE 的改善和安全性结果。
方法
我们招募了视神经脊髓炎谱系疾病 (NMOSD) 患者中接受 TPE 治疗的 ON 成年患者。主要结局是视觉 acuity scale (VOS) 的改善。我们描述了数据，并使用多变量逻辑回归来确定与反应相关的因素。
结果
83 例患者接受了 558 次 TPE 治疗。平均年龄为 40.9 ± 13.7 岁；73.5%为女性，50.1%为首次发作，10.7%为双侧。VOS 中位数：5（范围 [R]，2-7）。发病至 TPE 的中位时间为 8 天（R，1-32）。根据 Keegan 的标准，82.4%的患者有改善，78.3%的患者 VOS 至少提高 1 分。年龄和 TPE 前的 VOS 与改善有关。26%的疗程中出现低纤维蛋白原。
结论
TPE 对 NMOSD 患者的 ON 有效且安全。需要进行临床试验，使用治疗等效物。
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