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首页> 外文期刊>International Journal of Molecular Sciences >Treatment of the First Acute Relapse Following Therapeutic Plasma Exchange in Formerly Glucocorticosteroid-Unresponsive Multiple Sclerosis Patients—A Multicenter Study to Evaluate Glucocorticosteroid Responsiveness
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Treatment of the First Acute Relapse Following Therapeutic Plasma Exchange in Formerly Glucocorticosteroid-Unresponsive Multiple Sclerosis Patients—A Multicenter Study to Evaluate Glucocorticosteroid Responsiveness

机译:糖皮质激素无反应性多发性硬化症患者血浆置换后首次急性复发的治疗—评估糖皮质激素反应性的多中心研究

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摘要

Therapeutic options to treat multiple sclerosis (MS) relapses comprise glucocorticosteroids (GCS) as first-line and therapeutic plasma exchange (TPE) as second-line treatments in GCS-unresponsive patients. No guidelines exist for the treatment of another relapse following TPE. We retrospectively analyzed the responsiveness to GCS in a subsequent relapse following TPE in previously GCS-unresponsive MS patients. Thirty-seven patients with GCS-unresponsive MS relapses received TPE (relapse A). All patients developed another relapse after the completion of TPE and received GCS again (relapse B). The primary study endpoint was the clinical response to GCS and TPE. Marked improvement was defined as clinically significant improvement in function, moderate improvement as a definite change of symptoms without significant impact on function, no effect comprised unchanged symptoms, and deterioration a worsening of symptoms or new deficits. The secondary endpoint was an improvement in expanded disability status scale (EDSS) scoring. All patients were GCS-unresponsive during relapse A and received TPE. During GCS treatment of relapse B, marked improvement was observed in 10, moderate improvement in 24, and no effect in three patients. The EDSS decreased in 15 patients. GCS might remain the first-line relapse treatment following TPE in formerly GCS-unresponsive MS patients.
机译:对于无反应性GCS的患者,治疗多发性硬化症(MS)复发的治疗选择包括糖皮质激素(GCS)作为一线药物,治疗性血浆置换(TPE)作为二线治疗。目前尚无治疗TPE后再次复发的指南。我们回顾性分析了先前对GCS无反应的MS患者在TPE后复发中对GCS的反应。 GCS无反应的MS复发的37例患者接受了TPE(复发A)。 TPE完成后,所有患者均再次复发,并再次接受GCS治疗(复发B)。主要研究终点是对GCS和TPE的临床反应。显着改善定义为临床上功能的显着改善,中度改善为症状的明确改变,而对功能无明显影响,无影响包括症状不变,症状恶化或症状加重或出现新的缺陷。次要终点是扩大残疾状况量表(EDSS)评分的改善。所有患者在复发A期间均无GCS反应,并接受了TPE。在GCS治疗复发B期间,观察到10例明显改善,24例中度改善,三例无效。 15例患者的EDSS下降。对于以前对GCS无反应的MS患者,GCS可能仍是TPE术后的一线复发治疗。

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