AI Article Synopsis
- No systematic reviews currently exist evaluating plasma exchange (PE) or immunoadsorption (IA) for treating optic neuritis (ON) in demyelinating diseases, prompting the need for a meta-analysis.
- A search of multiple medical databases identified 35 studies with data on 1191 patients, revealing response rates of 68% for PE and 82% for IA during acute ON attacks, with improvement in visual outcomes noted.
- The analysis indicates that early treatment (within 21 days of symptom onset) enhances recovery, confirming that PE/IA is effective and safe, highlighting the importance of early intervention.
Article Abstract
Background: There are no systematic reviews yet that evaluated the effects of PE/IA in patients with optic neuritis (ON) in demyelinating diseases. A meta-analysis of available study is needed to further explore the value of plasma exchange (PE) or immunoadsorption (IA) in treating ON in demyelinating diseases.
Methods: All relevant articles published on PubMed, Web of Science, Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), VIP Database, Wanfang, Sinomed and ophthalmology professional websites were searched. Study characteristics, demographic characteristics, clinical features and outcome measures were extracted. Response rate, adverse events (AE) rate, serious adverse event (SAE) rate, the log of the minimum angle of resolution (logMAR), visual outcome scale (VOS) and expanded disability status scales (EDSS) were evaluated using a random-effects model.
Results: 35 studies were included between 1985 and 2020, containing 1191 patients. The response rates of PE and IA in acute attack of ON were 68% and 82% respectively. LogMAR (-0.60 to - 1.42) and VOS (-1.10 to -1.82) had been significantly improved from within 1 month to more than 1 month after PE treatment. Besides, we found that logMAR improved 1.78, 0.95 and 0.38, respectively ,when the time from symptom onset to the first PE/IA was less than 21 days, 21-28 days, and more than 28 days. The pooled mean difference of EDSS was -1.14.Adverse effects rate in patients with PE or IA were 0.20 and 0.06, respectively.
Conclusion: The meta-analysis provided evidence that PE/IA treatment was an effective and safe intervention, and it is recommended that early initiation of PE/IA treatment is critical.
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| http://dx.doi.org/10.1177/11206721211065218 | DOI Listing |
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