Document Detail


Meta-analysis of clinical studies of the efficacy of plasma exchange in the treatment of chronic progressive multiple sclerosis.
MedLine Citation:
PMID:  8770707     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To examine the hypothesis that 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.
Authors:
E C Vamvakas; A A Pineda; B G Weinshenker
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Publication Detail:
Type:  Journal Article; Meta-Analysis    
Journal Detail:
Title:  Journal of clinical apheresis     Volume:  10     ISSN:  0733-2459     ISO Abbreviation:  J Clin Apher     Publication Date:  1995  
Date Detail:
Created Date:  1996-09-25     Completed Date:  1996-09-25     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8216305     Medline TA:  J Clin Apher     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  163-70     Citation Subset:  IM    
Affiliation:
Blood Transfusion Service, Massachusetts General Hospital, Boston 02114, USA.
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MeSH Terms
Descriptor/Qualifier:
Chronic Disease
Disease Progression
Humans
Multiple Sclerosis / pathology,  therapy*
Odds Ratio
Plasma Exchange*
Prospective Studies
Randomized Controlled Trials as Topic
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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