Meta-analysis of clinical studies of the efficacy of plasma exchange in the treatment of chronic progressive multiple sclerosis

E. C. Vamvakas, A. A. Pineda, Brian G Weinshenker

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

OBJECTIVE: To examine the hypothesis thai addition of therapeutic plasma exchange (TPEX) to an immunosuppressive drug regimen increases that regimen's efficacy to halt the progression of chronic progressive multiple sclerosis (CPMS). METHODS: The literature was searched for prospective controlled clinical trials evaluating the efficacy of TPEX in CPMS. Six studies were eligible for meta-analysis. Their results were combined, using Cochran's and Peto's methods. Three outcome measures were studied: 1) the change in Kurtzke's disability status scale (DSS) scores, 2) the relative odds of neurologic decline by 1 or more DSS grades, and 3) the relative odds of neurologic improvement by 1 or more DSS grades, in the treatment versus the comparison group of patients. Reported results of neurologic evaluations at 6, 12, 24, and 36 months of follow-up were analyzed separately. RESULTS: TPEX significantly (P < .05) reduced the proportion of patients who experienced neurologic decline (by 1 or more DSS grades) at 12 months of follow-up (relative odds of decline = 0.441, 95% confidence interval = 0.210-0.929). CONCLUSIONS: There is a need for further clinical research into the possibility of a beneficial effect of TPEX in patients with CPMS likely to experience neurologic decline over the ensuring 12 months. Targeting treatment to a particular subgroup of CPMS patients may be necessary for TPEX to prove effective.

Original languageEnglish (US)
Pages (from-to)163-170
Number of pages8
JournalJournal of Clinical Apheresis
Volume10
Issue number4
DOIs
StatePublished - 1995

Fingerprint

Chronic Progressive Multiple Sclerosis
Plasma Exchange
Meta-Analysis
Nervous System
Odds Ratio
Therapeutics
Controlled Clinical Trials
Therapeutic Uses
Immunosuppressive Agents
Clinical Studies
Outcome Assessment (Health Care)
Confidence Intervals
Research
Pharmaceutical Preparations

Keywords

  • course
  • disability status scale
  • meta- analysis
  • multiple sclerosis
  • plasmapheresis
  • progression
  • therapeutic plasma exchange

ASJC Scopus subject areas

  • Hematology

Cite this

Meta-analysis of clinical studies of the efficacy of plasma exchange in the treatment of chronic progressive multiple sclerosis. / Vamvakas, E. C.; Pineda, A. A.; Weinshenker, Brian G.

In: Journal of Clinical Apheresis, Vol. 10, No. 4, 1995, p. 163-170.

Research output: Contribution to journalArticle

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