It's rare but devastating: an attack of MS that continues to rage despite treatment with high-dose steroids. Over 90% of people having severe MS attacks respond well to steroids, but the few who don't are very ill indeed. Investigators at Mayo Clinic, under the direction of Dr. Brian Weinshenker, studied the effect of a radical measure: shunting the patient's blood through a machine that separates blood cells from body fluid, or plasma, discarding the plasma, and returning all the blood cells to the patient in an albumin replacement fluid.
The scientists reason that by removing plasma. they remove all the antibodies, immune complexes, activated complement, and immune messenger chemicals it normally carries, thus taming destructive autoimmune activity. It is not proved that plasma exchange really does this. However, the carefully controlled study, which used fake exchanges as a control, but switched patients who didn't respond over to the other group, showed that plasma exchange benefits some people.
The 22 people in the study, 12 of whom had MS, were given a series of 7 treatments every other day for 2 weeks. One-third of the people with MS who got the treatment were considered successes. Almost everyone who got the real treatment developed anemia. The participants were followed for up to 3 years, and the successes had no additional MS attacks.
"This offers hope to some people for whom no previous treatment has proven effective", said Dr. Weinshenker when he presented the data at MS Week in Basil, Switzerland. The 2 hour procedure can be performed at most major medical centers without a hospital stay, but it is considered experimental for MS and may not be covered by health insurance. The cost of 7 treatments is approximately $18,000.
This article from Inside MS magazine, Winter 2000. The research was published in the December issue of Annals of Neurology.
Also known as Plasmapheresis
MDA Association on plasmapheresis
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THE UTILITY OF THERAPEUTIC PLASMAPHERESIS FOR NEUROLOGICAL DISORDERS
German plasmapheresis centre (Is this real?)
Advanced Critical Care Life Support Systems...Plasma Exchange Therapy
Aetna Coverage policy bulletin
CNN article: Plasma replacement helps some MS patients, study finds The Mayo study was presented Friday at a conference on MS in Basel, Switzerland. It was published in the journal Annals of Neurology in December, 1999.