Plasmapheresis in Treatment of Myasthenia Gravis

Abstract

Treatment of myasthenia gravis is still a rather difficult task, since there is no single tactic to use different drugs (corticosteroids, rituximab, immunoglobulins), especially since it is associated with a number of side effects. They are not able to remove the accumulating autoantibodies and immune complexes, the large size of which does not allow them to be excreted by the kidneys as well. Special problems of treatment arise when myasthenic crises develop associated with respiratory failure requiring artificial lungs ventilation. Plasmapheresis can help to solve this for it is possible to remove antibodies and other pathological metabolites. In addition, regular plasmapheresis is able not only to prevent exacerbations but also to reduce doses of the maintenance therapy with less risk of their side effects, which is confirmed by our own experience.

Our Clinical Experience in the Treatment of Myasthenia Gravis Acute Exacerbations with a Novel Nanomembrane-Based Therapeutic Plasma Exchange Technology

“…Our primary outcomes ( Table 2 ) support the advantages of TPE for superior ventilator status in terms of less intubation with IMV, more NIV, less tracheotomy, and quick response rate in MC reported by others [ 14 , 20 , 21 , 22 , 23 , 24 , 25 ]. Our secondary outcomes ( Table 4 ) support the role of TPE for early extubation (≤7 days) as well as the role of NIV for decreasing ventilation duration (≤7 days) reported by others [ 9 , 26 ].…”

“…Therefore, there is an unmet need for targeted immunomodulatory therapies, which has resulted in an ongoing campaign to develop safer and more effective treatments for MG [ 11 ]. The technological advances for a direct removal of auto-antibodies in patients with MG, such as immunoabsorption [ 12 ], double-filtration plasmapheresis [ 13 ], and nanomembrane-based TPE technology [ 14 ], pose new challenges and perspectives in this context.…”

Systems Pharmacology and Molecular Docking Reveals the Mechanisms of Nux Vomica for the Prevention of Myasthenia Gravis

“…Currently, patients with MG are mainly treated with corticosteroids, long-term immunosuppressive drugs, plasma exchange, or thymectomy [ 3 ]. However, their clinical application is limited due to their high costs and side effects, such as cardiac rhythm disorders and hypotension [ 4 ]. Hence, alternative therapies with higher efficacy and fewer side effects are needed for MG treatment.…”