Plasma Exchange in Secondary Progressive Multiple Sclerosis: Twenty-Five Year Follow-Up StudyBhupendra O Khatri1*, Sergey Tarima2, Michael P McQuillen3, John Kramer1, Mary Dukic1 and Cynthia Bellanger4
- Corresponding Author:
- Dr. Bhupendra Khatri
Wheaton Franciscan Healthcare
Center for Neurological Disorders
3237 S. 16th Street, Milwaukee, WI 53215, USA
E-mail: [email protected]
Received date: March 18, 2014; Accepted date: April 24, 2014; Published date: April 28, 2014
Citation: Khatri BO, Tarima S, McQuillen MP, Kramer J, Dukic M et al. (2014) Plasma Exchange in Secondary Progressive Multiple Sclerosis: Twenty-Five Year Follow-Up Study. J Mult Scler 1:102. doi:10.4172/2376-0389.1000102
Copyright: © 2014 Khatri B, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Secondary Progressive multiple sclerosis (SPMS) is a common form of MS with few approved and effective
therapies. Previous studies of therapeutic plasma exchange (PLEX) in SPMS have reported mixed results. The
purpose of this study was to evaluate long-term efficacy and safety of PLEX in SPMS. We retrospectively analyzed
25 years of PLEX therapy in SPMS to identify improvements in disease progression and disability as well as
potential predictors of therapeutic success. Using 271 patients, we show a significant improvement in Expanded
Disability Status Scale (EDSS) lasting for at least three years following a course of PLEX. Furthermore, disability
remained significantly improved or stabilized for seven years post-PLEX. Patients with continued and measureable
disability worsening in the previous three years are more apt to improve with PLEX. A small number of patients
(N=42) for whom PLEX was considered but denied by their insurance carriers, and who therefore received other
treatments, were also followed over the 25 year period. Progression of disability in this group was significantly worse
when compared with PLEX group. No major problems occurred during 8709 PLEX procedures. Peripheral vascular
access (venous or arterial) was utilized to avoid complications related to central line placement.
Because of the paucity of beneficial therapeutic interventions in SPMS and the relative safety and efficacy of
long-term PLEX, this therapy should be considered in this form of MS.