臨床神経学および脳神経外科ジャーナル

Apheresis in the Treatment of Neurological Disorders.

Abstract

Hazel Scarlett*

Plasma Exchange (PE) and Immunoadsorption (IA) are key therapeutic options for autoimmune diseases in a variety of medical fields. Their pathophysiological reasoning is primarily based on the elimination of autoantibodies and a favourable immune system regulation. From a theoretical standpoint, apheresis is a promising treatment approach since it works by removing pathogenic components rather than giving medicines that can have serious adverse effects. Multiple Sclerosis (MS) steroidrefractory relapse, myasthenia gravis, Autoimmune Encephalitis (AE), Guillain Barre Syndrome (GBS), and Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) are among the neurological indications. Although PE and IA are frequently used in clinical practise, evidence for their efficacy and safety in the aforementioned indications is generally lacking. This is due to the fact that drugs and medical devices are treated differently in terms of regulatory approvals in most countries, that is indication-specific phase III studies are generally not required in order to gain approval. As a result, less is known regarding the efficacy of PE and IA in comparison to other treatment choices and to each other. Similarly, there is a complete dearth of understanding regarding the best treatment regimens for PE and IA.