Rescue immunoadsorption treatment for neuromyelitis optica spectrum disorder attacks unresponsive to intravenous methylprednisolone

J Neuroimmunol. 2021 Jul 15:356:577604. doi: 10.1016/j.jneuroim.2021.577604. Epub 2021 May 7.

Abstract

We aimed to evaluate the value of immunoadsorption (IA) treatment after the failure of intravenous methylprednisolone (IVMP) therapy for neuromyelitis optica spectrum disorder (NMOSD). Sixty-one NMOSD attacks unresponsive to IVMP were included: 22 patients received rescue IA (IVMP+IA), 24 underwent rescue plasma exchange (PE) (IVMP+PE), and 21 received no further rescue therapy (IVMP alone). The improvement frequencies were higher in the IVMP+IA and IVMP+PE groups than in the IVMP-alone group (P = 0.024). The effective period for IA treatment may be longer than previously thought. IA treatment for IVMP-resistant NMOSD attacks was effective and comparable to PE treatment.

Keywords: Aquaporin 4; Immunoadsorption; Methylprednisolone; Myelitis; Neuromyelitis optica; Plasmapheresis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Intravenous
  • Adult
  • Anti-Inflammatory Agents / administration & dosage*
  • China / epidemiology
  • Databases, Factual
  • Female
  • Humans
  • Male
  • Methylprednisolone / administration & dosage*
  • Middle Aged
  • Neuromyelitis Optica / diagnosis*
  • Neuromyelitis Optica / immunology
  • Neuromyelitis Optica / therapy*
  • Plasmapheresis / methods*
  • Treatment Outcome
  • Young Adult

Substances

  • Anti-Inflammatory Agents
  • Methylprednisolone