Clinical Report: Impact of Therapeutic Plasma Exchange on Functional Outcomes

Overview

This study evaluates the effects of therapeutic plasma exchange (TPE) on functional outcomes in patients with various neurological disorders. Significant improvements in the Modified Rankin Scale scores were observed in conditions such as multiple sclerosis, myasthenia gravis, and Guillain-Barré syndrome following TPE.

Background

Neurological disorders represent a significant burden on healthcare systems due to their associated morbidity. Therapeutic plasma exchange (TPE) is a treatment that aims to remove harmful substances from the plasma.

Data Highlights

Key Findings

• TPE significantly improved mRS scores in multiple sclerosis, myasthenia gravis, and Guillain-Barré syndrome (all p < 0.001).
• Improvements were also noted in neuromyelitis optica spectrum disorder (p = 0.008), chronic inflammatory demyelinating polyneuropathy (p = 0.007), and autoimmune encephalitis (p = 0.018).
• No significant improvement was observed in other neurological disorders (p = 0.234).
• The overall mortality rate among patients was 6.8%, with no deaths directly related to TPE.
• Common comorbidities among deceased patients included hypertension, diabetes mellitus, and cardiovascular disease.
• Due to the retrospective nature of the study, causal inferences regarding TPE's effectiveness cannot be established.

Clinical Implications

Clinicians should consider patient selection carefully, taking into account comorbidities.

Conclusion

Further prospective studies are needed to confirm these findings.

Related Resources & Content

1. American Society for Apheresis, Guidelines on the Use of Therapeutic Apheresis in Clinical Practice, 2023 -- Evidence‐Based Approach
2. European Academy of Neurology/Peripheral Nerve Society, European Journal of Neurology, 2021 -- Diagnosis and treatment of chronic inflammatory demyelinating polyradiculoneuropathy
3. Consensus Recommendations for the Diagnosis and Treatment of Neuromyelitis Optica Spectrum Disorders, MENACTRIMS Guidelines, 2026 -- PubMed
4. The Journal of Clinical Endocrinology & Metabolism — Impact of Therapeutic Plasma Exchange on Levels of Calcium, Phosphate, Parathyroid Hormone, and Fibroblast Growth Factor-23
5. Frontiers in Medicine — Case Report: Albumin combined with plasma exchange in the treatment of refractory thrombotic thrombocytopenic purpura
6. Intensive Care Medicine — Impact of Recombinant Erythropoietin on Long-Term Outcomes Following Moderate to Severe Traumatic Brain Injury
7. Critical Care (Springer) — The Impact of Timing and Patient Characteristics on the Efficacy of Plasma Exchange in Amatoxin-Related Acute Liver Failure
8. Guidelines on the Use of Therapeutic Apheresis in Clinical Practice – Evidence‐Based Approach from the Writing Committee of the American Society for Apheresis: The Ninth Special Issue
9. European Academy of Neurology/Peripheral Nerve Society guideline on diagnosis and treatment of chronic inflammatory demyelinating polyradiculoneuropathy: Report of a joint Task Force—Second revision - Van den Bergh - 2021 - European Journal of Neurology - Wiley Online Library
10. Consensus Recommendations for the Diagnosis and Treatment of Neuromyelitis Optica Spectrum Disorders (NMOSD): The MENACTRIMS Guidelines - PubMed