Plasmapheresis is a treatment recommended for patients with severe relapsing-remitting multiple sclerosis (RRMS) who do not respond to steroid treatment.

What is multiple sclerosis?

MS is a serious neurological condition characterized by the immune system mistakenly attacking the protein coat that protects nerve fibers. The most common form of MS is RRMS. When a relapse occurs, symptoms return or intensify for 24 hours or more. These attacks are caused by flare-ups of the immune system attacking the nervous system and causing new damage. After the relapse is over, patients may partially or completely recover. This is called a remission.

Relapses are often treated first with corticosteroids. However, not all relapses respond to corticosteroid treatment. In these cases, other treatments are recommended, including plasmapheresis.

What is plasmapheresis?

Plasmapheresis is a process by which the blood is “cleaned” by removing the plasma (the liquid portion of blood) and returning the blood cells to the patient’s body. Blood is withdrawn from the patient in a process similar to the one used when giving blood. The plasma is removed by a machine from one arm and the blood cells in replacement plasma are returned to the patient through the other arm. The process takes one to two hours and patients need to be treated every day for five to seven days. Patients may be treated as inpatients or outpatients, depending on a doctor’s recommendation.

Plasmapheresis is thought to help MS patients by removing inflammatory factors from the plasma. Removing these factors can reduce inflammation in some cases of MS, treating the relapse and speeding remission.

Plasmapheresis research for MS

The guidelines for the use of plasmapheresis in MS were published in the journal Neurology. The authors examined the literature from 1995 to 2009 and recommended that plasmapheresis be used in cases of RRMS that do not respond to steroid treatments. They also found that plasmapheresis is not effective in treating primary progressive or secondary progressive MS.

Other information

Side effects of plasmapheresis can include clotting problems and infections.

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