Lafuente-Gómez G, Anaya-Fernández Lomana F, Gómez-Roldós A, García-Domínguez J M, Lozano-Ros A, Cuello J P, Higueras-Hernández Y, Meldaña-Rivera A, Goicochea-Briceño H, Leal-Hidalgo R, De Miguel-Sánchez de Puerta C J, Martínez-Ginés M L
Hospital General Universitario Gregorio Marañón, Madrid, España.
Rev Neurol. 2022 May 16;74(10):340-342. doi: 10.33588/rn.7410.2021184.
Relapsing-remitting multiple sclerosis (RRMS) treatment has significantly changed in recent years because of the discovery of new molecules that have shown efficacy as maintenance treatment. However, the classical treatment for acute attacks is based on corticosteroids administration, being the periodical plasmapheresis the alternative treatment in the case of refractory patients. We introduce a case of relapsing-remitting multiple sclerosis treated with a classical acute attacks therapy: plasmapheresis.
The case of a 39-year-old patient who was diagnosed with relapsing-remitting multiple sclerosis, postpartum debut and aggresive course, who, after suboptimal response to disease modifying therapies (alemtuzumab and ocrelizumab), receives combination treatment with outpatient periodic plasmapheresis every 3 weeks as maintenance therapy. Good tolerance and response. Clinical stability with this treatment. She has not required new hospital admissions for acute attacks of multiple sclerosis from February 2020 to March 2021.
Although more specific studies are needed, this case provides information on a potential new maintenance treatment for patients with relapsing-remitting multiple sclerosis refractory to disease-modifying drug therapies.
近年来，由于发现了具有维持治疗疗效的新分子，复发缓解型多发性硬化症（RRMS）的治疗发生了显著变化。然而，急性发作的经典治疗方法是使用皮质类固醇，对于难治性患者，定期血浆置换是替代治疗方法。我们介绍一例采用经典急性发作疗法（血浆置换）治疗的复发缓解型多发性硬化症病例。
一名39岁患者被诊断为复发缓解型多发性硬化症，产后发病且病情进展迅速，在对疾病修正疗法（阿仑单抗和奥瑞珠单抗）反应欠佳后，接受每3周一次的门诊定期血浆置换联合治疗作为维持治疗。耐受性良好且反应良好。通过这种治疗实现了临床稳定。从2020年2月到2021年3月，她未因多发性硬化症急性发作而再次住院。
尽管需要更多具体研究，但该病例为复发缓解型多发性硬化症患者提供了一种针对疾病修正药物治疗无效的潜在新维持治疗方法的信息。
