Double-blind study of true vs. sham plasma exchange in patients treated with immunosuppression for acute attacks of multiple sclerosis.

Abstract:

:We enrolled 116 patients in a multicenter, randomized, double-blind controlled trial of an 8-week course of 11 plasma exchange (PE) treatments in exacerbations of MS. The control group received sham PE, and both groups received identical treatment with IM ACTH and oral cyclophosphamide. Serum IgG decreased in the PE and sham treatment groups by 76% versus 22% by treatment 5, and by 64% versus 14% by treatment 11. PE also produced significant reductions in IgA, IgM, C3, and fibrinogen. PE patients had moderately enhanced improvement at 2 weeks relative to the sham group. PE patients with relapsing/remitting disease had significantly enhanced improvement at 4 weeks and there was also an increased improvement at 12 months, although this latter effect disappeared when we analyzed relapsing/remitting patients as a separate subgroup. Life table analysis showed the median time to recover preattack disability status was shorter in PE- than in sham-treated relapsing/remitting patients (4 vs. 13 weeks), a result confirmed by raw disability status scores in which there was recovery to their average preattack disability score by 3 months. PE given with ACTH plus cyclophosphamide enhances recovery from an exacerbation of disease in relapsing/remitting patients, although we observed no clear long-term benefits.

journal_name

Neurology

journal_title

Neurology

authors

Weiner HL,Dau PC,Khatri BO,Petajan JH,Birnbaum G,McQuillen MP,Fosburg MT,Feldstein M,Orav EJ

doi

10.1212/wnl.39.9.1143

subject

Has Abstract

pub_date

1989-09-01 00:00:00

pages

1143-9

issue

9

eissn

0028-3878

issn

1526-632X

journal_volume

39

pub_type

临床试验,杂志文章,随机对照试验
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    更新日期:2002-05-14 00:00:00

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    abstract:BACKGROUND:Multiple sclerosis (MS) is a neurodegenerative disease associated with marked impairments in health-related quality of life (HRQoL). Although standard clinical end points such as the Expanded Disability Status Scale and annualized relapse rate remain useful in assessing MS activity and severity, these measur...

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    更新日期:2010-04-27 00:00:00

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    更新日期:2000-07-12 00:00:00

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    更新日期:2000-02-22 00:00:00

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    abstract::Prostaglandins B1 and B2 were topically applied to the pial vessels of mice and arteriolar constriction was observed. This constriction could be significantly increased if serotonin was added to B1, but not when norepinephrine was added. Response to B2 was not enhanced by the simultaneous addition of either serotonin ...

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    pub_type: 杂志文章

    doi:10.1212/wnl.25.12.1169

    authors: Rosenblum WI

    更新日期:1975-12-01 00:00:00

  • Phenobarbital and phenytoin in neonatal seizures: metabolism and tissue distribution.

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    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.31.9.1107

    authors: Painter MJ,Pippenger C,Wasterlain C,Barmada M,Pitlick W,Carter G,Abern S

    更新日期:1981-09-01 00:00:00

  • Imaging of neuroinflammation in migraine with aura: A [11C]PBR28 PET/MRI study.

    abstract:OBJECTIVE:To determine if migraine with aura is associated with neuroinflammation, which has been suggested by preclinical models of cortical spreading depression (CSD) as well as imaging of human pain conditions. METHODS:Thirteen migraineurs with aura and 16 healthy controls received integrated PET/MRI brain scans wi...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0000000000007371

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    更新日期:2019-04-23 00:00:00

  • Three-year follow-up of prospective trial of focused ultrasound thalamotomy for essential tremor.

    abstract:OBJECTIVE:To test the hypothesis that transcranial magnetic resonance-guided focused ultrasound (tcMRgFUS) thalamotomy is effective, durable, and safe for patients with medication-refractory essential tremor (ET), we assessed clinical outcomes at 3-year follow-up of a controlled multicenter prospective trial. METHODS:...

    journal_title:Neurology

    pub_type: 杂志文章,随机对照试验

    doi:10.1212/WNL.0000000000008561

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  • Transient global amnesia: clinical and electroencephalographic findings in 10 cases.

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    pub_type: 杂志文章

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    更新日期:1979-06-01 00:00:00

  • Branch occlusive disease: clinical and magnetic resonance angiography findings.

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    更新日期:2012-03-20 00:00:00

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    pub_type: 杂志文章,评审

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    更新日期:2007-02-13 00:00:00

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    pub_type: 杂志文章,多中心研究

    doi:10.1212/WNL.0000000000000188

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    更新日期:2014-03-11 00:00:00

  • Clinical characteristics of transient ischemic attacks in black patients.

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    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.41.9.1410

    authors: Weisberg LA

    更新日期:1991-09-01 00:00:00

  • Loss of TBK1 is a frequent cause of frontotemporal dementia in a Belgian cohort.

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    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0000000000002220

    authors: Gijselinck I,Van Mossevelde S,van der Zee J,Sieben A,Philtjens S,Heeman B,Engelborghs S,Vandenbulcke M,De Baets G,Bäumer V,Cuijt I,Van den Broeck M,Peeters K,Mattheijssens M,Rousseau F,Vandenberghe R,De Jonghe P,Cras P

    更新日期:2015-12-15 00:00:00

  • Association of aortic plaque with intracranial atherosclerosis in patients with stroke.

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    journal_title:Neurology

    pub_type: 杂志文章

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    authors: Nam HS,Han SW,Lee JY,Ahn SH,Ha JW,Rim SJ,Lee BI,Heo JH

    更新日期:2006-10-10 00:00:00

  • Effect of comorbidity on mortality in multiple sclerosis.

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    journal_title:Neurology

    pub_type: 杂志文章

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    更新日期:2015-07-21 00:00:00

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    journal_title:Neurology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Smith AG,Bromberg MB,Singleton JR,Forshew DA

    更新日期:1999-01-15 00:00:00

  • Botulinum toxin A for spasticity, muscle spasms, and rigidity.

    abstract::We studied the effects of botulinum toxin A in 12 patients with spasticity and in eight patients with rigidity. The study design was a double-blind, placebo-controlled crossover trial with botulinum toxin A versus saline. Using the Ashworth Scale for spasticity and the Unified Parkinson's Disease Rating Scale for rigi...

    journal_title:Neurology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1212/wnl.45.4.712

    authors: Grazko MA,Polo KB,Jabbari B

    更新日期:1995-04-01 00:00:00

  • Reasons for exclusion from thrombolytic therapy following acute ischemic stroke.

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    pub_type: 杂志文章

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    authors: Cocho D,Belvís R,Martí-Fàbregas J,Molina-Porcel L,Díaz-Manera J,Aleu A,Pagonabarraga J,García-Bargo D,Mauri A,Martí-Vilalta JL

    更新日期:2005-02-22 00:00:00

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    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.41.12.1923

    authors: Pulst SM,Riccardi VM,Fain P,Korenberg JR

    更新日期:1991-12-01 00:00:00

  • Randomized, placebo-controlled trial of rofecoxib in the acute treatment of migraine.

    abstract:OBJECTIVE:To investigate the clinical profile of rofecoxib, a long-acting (approximately 17-hour half-life) selective cyclo-oxygenase-2 inhibitor, for the acute treatment of migraine. METHODS:A randomized, double-blind, placebo-controlled, parallel-group study was conducted. Patients age > or =18 treated a moderate or...

    journal_title:Neurology

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1212/01.wnl.0000123260.61631.c4

    authors: Silberstein S,Tepper S,Brandes J,Diamond M,Goldstein J,Winner P,Venkatraman S,Vrijens F,Malbecq W,Lines C,Visser WH,Reines S,Yuen E

    更新日期:2004-05-11 00:00:00

  • Meta-analysis of pharmacogenetic interactions in amyotrophic lateral sclerosis clinical trials.

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    pub_type: 杂志文章,meta分析,评审

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    更新日期:2017-10-31 00:00:00

  • Fatigue in Parkinson's disease.

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    pub_type: 杂志文章

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    更新日期:1993-10-01 00:00:00

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    doi:10.1212/wnl.43.1_part_1.153

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