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

Rui Li; Jingqi Wang; Cong Li; Xiangfu Liu; Muyang Chu; Yanyu Chang; Yuge Wang; Xia Wang; Boguang Yu; Li Ling; Hui Yang; Huan Yang; Xueqiang Hu; Wei Qiu

doi:10.1016/j.jneuroim.2021.577604

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.

Authors

Rui Li¹, Jingqi Wang¹, Cong Li¹, Xiangfu Liu², Muyang Chu³, Yanyu Chang¹, Yuge Wang¹, Xia Wang⁴, Boguang Yu⁵, Li Ling³, Hui Yang⁶, Huan Yang⁷, Xueqiang Hu¹, Wei Qiu⁸

Affiliations

¹ Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China.
² Department of Blood Transfusion, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China.
³ Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou 510060, China.
⁴ Neurology Department, The Sixth People's Hospital of Huizhou, Huizhou 516200, China.
⁵ Guangdong Provincial Key Laboratory of Hemoadsorption Technology, Guangzhou 510700, China.
⁶ State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center of Sun Yat-sen University, Guangzhou 510060, China.
⁷ Department of Neurology, Xiangya Hospital of Central South University, Changsha 410008, China.
⁸ Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China. Electronic address: [email protected].

PMID: 33992860
DOI: 10.1016/j.jneuroim.2021.577604

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