Patients with neuromyelitis optica spectrum disorder (NMOSD), multiple sclerosis (MS), and myasthenia gravis (MG) showed significant improvements after treatment with plasmapheresis, according to results from the Japan-Plasmapheresis Outcome and Practice Patterns Study published in Therapeutic Apheresis and Dialysis.

Statistically significant improvements in the modified Rankin Scale (mRS) and Barthel Index scores were reported for patients with MG, MS, and NMOSD. Significant improvements were also observed in a gross group that included MG, MS, NMOSD, chronic inflammatory demyelinating polyneuropathy (CIDP), and Guillain-Barré syndrome (GBS), among others.

Of the 160 patients in the study who were evaluated using mRS scores, 14 (8.8%) showed improvements of 2 or more points and 84 (52.5%) had a 1-point improvement.

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“This study highlights the latest status of plasmapheresis in autoimmune neurological diseases in Japan. Plasmapheresis may be considered an efficient therapy for autoimmune neurological diseases such as MG, MS, NMOSD, CIDP, and GBS, with a low frequency of adverse events,” the authors said.

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The disease most commonly treated with plasmapheresis at the 12 sites in the trial was MG, with 82 patients. The next most common was autoimmune encephalitis/encephalopathy with 40 patients.

The most commonly prescribed form of plasmapheresis was immunoadsorption plasmapheresis (IAPP) in 620 out of 887 treatments among all 210 patients. Plasma exchange (PE) treatment (213) and double-filtration plasmapheresis (54) made up the remainder of the treatments.

MG was most commonly treated with PE (53.7%) and IAPP (41.5%), while MS and NMOSD were mainly treated with IAPP (56.7% and 83.3%, respectively).

No serious side effects were observed during the study. Side effects only occurred in 10 of the 210 patients (4.8%) and following 11 of the 887 treatments (1.2%). These side effects included nausea (1.9%), vomiting (0.5%), device-related infection (0.5%), hemolysis (0.5%), dyspnea (0.5%), and fibrinogen decrease (0.5%).


Lin Y, Oji S, Miyamoto K, Narita T, Kameyama M, Matsuo H. Real-world application of plasmapheresis for neurological disease: results from the Japan-Plasmapheresis Outcome and Practice Patterns Study (J-POPPS). Ther Apher Dial. Published online June 29, 2022. doi:10.1111/1744-9987.13906