Safety of plasma exchange therapy in patients with myasthenia gravis.

Division of Neurology, University Health Network, University of Toronto, 5EC-309, 200 Elizabeth Street, Toronto, Ontario, M5G 2C4, Canada.

Muscle & nerve 2013 Apr

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Plasma exchange (PLEX) is effective in myasthenia gravis (MG), but there are concerns about its safety. We collected data prospectively from 42 patients randomized to PLEX treatment in a comparison study with intravenous immunoglobulin (IVIg). Detailed information on the PLEX treatment methodology and adverse events are reported. Forty of 42 patients completed PLEX. Ninety percent were treated in an outpatient setting. Fifty-five percent had no complications, and 45% had mild-moderate reactions that did not require stopping treatment; the majority were citrate reactions and peripheral vascular issues that were easily treated. Fifty-seven percent of patients responded to treatment, and 83% completed PLEX via peripheral venous access. Two patients had severe adverse events: 1 related and 1 unrelated to PLEX. Comorbid disease and age did not predict reactions. PLEX is safe, effective, and well tolerated in patients with MG. Our results do not raise concerns about the safety of PLEX in patients with moderate-severe MG. Copyright © 2012 Wiley Periodicals, Inc.