Objective:

To evaluate functional outcomes following therapeutic plasma exchange in patients with selected neurological disorders at National Guard Health Affairs (NGHA) in Jeddah, Saudi Arabia.

Approach:

• Study Design: Retrospective cohort study analyzing 133 patients diagnosed with various neurological disorders who received TPE between August 2015 and December 2022.
• Assessment Method: Effectiveness of TPE assessed using the Modified Rankin Scale (mRS) before and 90 days after the final TPE session.
• Statistical Analysis: Wilcoxon signed-rank tests and Mann–Whitney U test, with significance set at p < 0.05.

Key Findings:

• Significant improvements in mRS scores following TPE for multiple sclerosis (MS), myasthenia gravis (MG), and Guillain-Barré syndrome (GBS) (all p < 0.001).
• Improvements also noted for neuromyelitis optica spectrum disorder (NMOSD) (p = 0.008), chronic inflammatory demyelinating polyneuropathy (CIDP) (p = 0.007), and autoimmune encephalitis (AE) (p = 0.018).
• No significant improvement in other neurological disorders (p = 0.234).
• Overall mortality was 6.8%, with no TPE-related deaths.

Interpretation:

Due to the retrospective design and potential confounding factors, causal inferences cannot be established.

Limitations:

• Retrospective design limits causal inference.
• Potential confounding factors not controlled include comorbidities and variations in treatment protocols.

Conclusion:

Further prospective studies are warranted to evaluate the role of TPE and optimize patient selection.