plasma exchange (PLEX) / Mayo Clinic, Terumo Corp - LARVOL DELTA

Cost analysis of treatment with therapeutic plasma exchange versus treatment with intravenous immunoglobulins in patients with immune-based neurological diseases. Proposal for optimizing the use of plasmatic blood products. (PubMed, Neurologia (Engl Ed)) - "The use of TPE in the first line in pathologies in which the clinical results do not present significant differences with the IGEV, optimizes the use of blood products and can lead to economic savings. It is necessary to expand this study by including an analysis of the efficacy in our series, as well as the adverse events associated with each type of treatment together with other expenses derived from personnel and hospital admission costs versus the use of outpatient resources (pheresis room)."

HEOR • Journal • CNS Disorders • Immunology

Interesting rare case of polyarteritis nodosa related to hepatitis B virus and plasma exchange role? - A case report and review of the literature. (PubMed, Asian J Transfus Sci) - "The present index case indicates that antiviral combined with plasma exchange after short-term corticosteroids is an effective therapy for HBV-PAN. TPE can be used as adjuvant therapy along with antiviral therapy in a rare disease like HBV-related PAN."

Journal • Review • Cardiovascular • Hepatitis B • Hepatology • Infectious Disease • Inflammation • Musculoskeletal Diseases • Musculoskeletal Pain • Orthopedics • Pain • Rare Diseases • Vasculitis

Evolving Experience with Aboi Transplantation [Board No. B168] (ATC 2023) - "Desensitization included Myfortic (d -30), Rituximab 500mg (d -21), PLEX #1-7 (d -16 to d -7), IVIG (d -5) prior to transplant. Current ABOi protocols are more compact and focused than those of past decades where excessive PLEX sessions both pre-& post-transplant resulted in significant complications including bleeding and infections. Previous UNOS reviews have also suggested ABOi transplantation is associated with poorer outcomes than standard LD transplantation. Here, we show that good outcomes can be achieved with limited PLEX sessions that have few complications."

Infectious Disease • Transplantation

Modifications to therapeutic plasma exchange to achieve rapid exchange on cardiopulmonary bypass prior to pediatric cardiac transplant. (PubMed, J Clin Apher) - "We feel that this procedure can be rapidly and safely performed in HLA sensitized pediatric patients on CPB to limit the risk of antibody mediated rejection of their heart transplant."

Journal • Antibody-mediated Rejection • Cardiovascular • Endocrine Disorders • Hypotension • Pediatrics • Transplantation

Therapeutic plasma exchange in HELLP syndrome: A life savior. (PubMed, Asian J Transfus Sci) - "Our data showed that TPE improved the treatment outcome in patients with HELLP syndrome despite being a Category III and IV indication among postpartum and antenatal females, respectively. However, a timely diagnosis and management are of paramount importance for a favorable outcome. TPE needs to be performed within 24 h of the diagnosis postdelivery when the patient is not responsive to the usual therapies, especially in class I HELLP syndrome."

Journal • Gynecology • Hematological Disorders • Thrombocytopenia

Initiation of a National Cellular Therapy Collection Adverse Reaction Tracking System (AABB 2022) - "While fewer than 1% of total cellular collection procedures resulted in a reported AR, standardized AR reporting identifies vascular access-related complications and vasovagal events as key areas for innovation and quality control. This initiative remains active and our organization is currently working to include therapeutic apheresis procedures such as plasma exchange and red blood cell exchange in future reports. Efforts are also planned to ensure that all relevant events are captured by the reporting system."

Allergy • Cardiovascular • Hematological Disorders • Hypotension

Therapeutic Plasma Exchange in Neuromyelitis Optica Spectrum Disorders-Experience from Tertiary Care Center in North India. (PubMed, Neurol India) - "One patient had relapsed and underwent a second TPE cycle. The addition of TPE as a part of therapy is effective and safe in acute exacerbations of NMOSD."

Journal • Allergy • CNS Disorders • Hypotension • Neuromyelitis Optica Spectrum Disorder • Ocular Inflammation • Ophthalmology • Optic Neuritis • Rare Diseases

Comparison of Therapeutic Plasma Exchange with Centrifugation and Filter Technique with a Focus on Efficacy, Safety, Platelet Loss and Patients' Comfort (ERA-EDTA 2022) - "An advantage regarding cell loss (RBC) was seen for cTPE, platelet loss tended to be higher with mTPA, but without statistical significance. Finally, as a result of shorter duration, patients’ comfort was significantly higher with cTPE."

Clinical • CNS Disorders • Immunology • Inflammation • Multiple Sclerosis

Role of therapeutic plasma exchange in the management of COVID-19-induced cytokine storm syndrome. (PubMed, Transfus Apher Sci) - "While TPE may offer a valuable option to treat patients with COVID-19-induced CSS, high-quality randomized controlled clinical trials are needed to confirm its potential clinical benefits, feasibility, and safety. Moreover, clear criteria should be established to identify patients with CSS who might benefit from TPE."

Clinical • Cytokine storm • Journal • Review • Hematological Disorders • Immune Modulation • Infectious Disease • Inflammation • Novel Coronavirus Disease • Respiratory Diseases • CRP • IL6

Consensus recommendation on the use of therapeutic plasma exchange for adult neurological diseases in Southeast Asia from the Southeast Asia therapeutic plasma exchange consortium. (PubMed, J Cent Nerv Syst Dis) - "TPE as second-line treatment is indicated for IVIg or corticosteroids refractory cases of ADEM, NMOSD (acute), MG, and NMDAR/LGI1/CASPR2/Hashimoto's encephalitis. With better diagnosis, treatment initiation with TPE is a sustainable and effective immunotherapy for autoimmune neurological diseases in SEA."

Journal • Review • CNS Disorders • Immunology • Neuromyelitis Optica Spectrum Disorder • Pain

MultiPLEX Study: Maintenance Plasma Exchange for Neuromyelitis Optica (clinicaltrials.gov) - P=N/A; N=9; Completed; Sponsor: Mayo Clinic; Active, not recruiting ➔ Completed; N=14 ➔ 9

Clinical • Enrollment change • Trial completion • CNS Disorders • Neuromyelitis Optica Spectrum Disorder • Rare Diseases

The Role of Plasma Exchange in the Treatment of Refractory Autoimmune Neurological Diseases: a Narrative Review. (PubMed, J Neuroimmune Pharmacol) - "Success rates can also differ within 'one' disease: e.g. response rates to PLEX are considerably higher in refractory relapsing remitting MS compared to primary or secondary progressive MS. When sufficient efforts are made to correctly pinpoint the diagnosis along with the type and subtype of refractory autoimmune disease, PLEX and other immunotherapies can play a valuable role in the patient management."

Journal • Review • CNS Disorders • Endocrine Disorders • Hematological Malignancies • Immune Modulation • Immunology • Inflammation • Multiple Myeloma • Multiple Sclerosis • Myasthenia Gravis • Neuromyelitis Optica Spectrum Disorder • Oncology • Pain • Rare Diseases

Variable response to Therapeutic plasma exchange in pediatric Anti-NMDA Receptor encephalitis. (PubMed, Transfus Clin Biol) - "Early diagnosis and timely initiation of therapeutic plasma exchange along with immunosuppressive therapy hasten the recovery, duration of hospitalization and yield a better outcome."

Clinical • Journal • CNS Disorders • Pediatrics • Psychiatry

MultiPLEX Study: Maintenance Plasma Exchange for Neuromyelitis Optica (clinicaltrials.gov) - P=N/A; N=14; Active, not recruiting; Sponsor: Mayo Clinic; Trial completion date: Dec 2020 ➔ Dec 2022; Trial primary completion date: Dec 2020 ➔ Dec 2022

Clinical • Trial completion date • Trial primary completion date • CNS Disorders • Complement-mediated Rare Disorders • Neuromyelitis Optica Spectrum Disorder • Rare Diseases

Reverse takotsubo cardiomyopathy in fulminant COVID-19 associated with cytokine release syndrome and resolution following therapeutic plasma exchange: a case-report. (PubMed, BMC Cardiovasc Disord) - "He was admitted to the intensive care unit (ICU) for mechanical ventilation and vasopressors, plus antivirals (lopinavir/ritonavir), and prophylactic anticoagulation. Stress-cardiomyopathy may complicate the course of fulminant COVID-19 with associated CRS. If inotropic therapy fails, TPE without protective antibodies may help rescue the critically ill patient."

Clinical • Cytokine release syndrome • Journal • Cardiomyopathy • Cardiovascular • Critical care • Fatigue • Immunology • Infectious Disease • Musculoskeletal Pain • Novel Coronavirus Disease • Pain • Psychiatry • Respiratory Diseases

A pilot study of therapeutic plasma exchange for serious SARS CoV-2 disease (COVID-19): A structured summary of a randomized controlled trial study protocol. (PubMed, Trials) - "The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest of expediting dissemination of this material, the familiar formatting has been eliminated; this letter serves as a summary of the key elements of the full protocol."

Clinical • Journal • Acute Respiratory Distress Syndrome • Allergy • Hematological Disorders • Hemophilia • Infectious Disease • Nephrology • Novel Coronavirus Disease • Palliative care • Renal Disease • Respiratory Diseases

APPLICATION OF BIG DATA IN RARE DISEASE MANAGEMENT- TREATMENT COST OF THERAPEUTIC PLASMA EXCHANGE VERSUS IMMUNOGLOBULINS IN AN OUTPATIENT SETTING (ISPOR-EU 2019) - "CONCLUSIONS Using large scale data coming from outpatient patients diagnosed with four selected neuromuscular conditions (GBS, CIDP, MG without and with acute exacerbation), therapy costs with TPE were found to be significantly lower when compared to IVIg therapy costs. Hospitals investing in therapeutic plasma exchange are likely to experience savings in their treatment costs."

Clinical

COMPARING ECONOMIC IMPACT OF CENTRIFUGAL AND MEMBRANE THERAPEUTIC PLASMA EXCHANGE IN A SINGLE INSTITUTION IN THAILAND (ISPOR-EU 2019) - "The economic evaluation between these two plasma exchange techniques showed centrifugal TPE had a better cost benefit than membrane TPE. For a hospital with similar characteristics, we expect positive economic impact with application of centrifugal TPE."

Clinical • HEOR

APPLICATION OF BIG DATA IN RARE DISEASE MANAGEMENT- TREATMENT COST OF THERAPEUTIC PLASMA EXCHANGE VERSUS IMMUNOGLOBULINS IN AN INPATIENT SETTING (ISPOR-EU 2019) - "CONCLUSIONS Using large scale data coming from hospitalized patients diagnosed with four selected neuromuscular conditions (GBS, CIDP, MG without and with acute exacerbation), therapy costs with TPE were found to be significantly lower when compared to IVIg therapy costs. Hospitals investing in therapeutic plasma exchange are likely to experience savings in their treatment costs."

Clinical

UNDERSTANDING THE ECONOMIC IMPACT OF THERAPEUTIC PLASMA EXCHANGE- A SINGLE INSTITUTION STUDY IN PUNE, INDIA (ISPOR-EU 2019) - "The economic evaluation between these two plasma exchange methods showed centrifugal TPE had a better cost benefit than membrane TPE."

Clinical • HEOR

MEASURING THE ECONOMIC IMPACT OF THERAPEUTIC PLASMA EXCHANGE- A SINGLE INSTITUTION STUDY IN XIAMEN, CHINA (ISPOR-EU 2019) - "The economic evaluation between these two plasma exchange methods showed centrifugal TPE had a better cost benefit than membrane TPE."

Clinical • HEOR

ECONOMIC EVALUATION OF CENTRIFUGAL AND MEMBRANE THERAPEUTIC PLASMA EXCHANGE IN TAIWAN (ISPOR-EU 2019) - "The economic evaluation between these two plasma exchange techniques showed centrifugal TPE had a better cost benefit than membrane TPE."

HEOR

ECONOMIC BENEFIT OF CENTRIFUGAL VERSUS MEMBRANE THERAPEUTIC PLASMA EXCHANGE- A SINGLE INSTITUTION EXPERIENCE IN VIETNAM (ISPOR-EU 2019) - "The economic evaluation between these two plasma exchange techniques showed centrifugal TPE had a better cost benefit than membrane TPE. For a hospital with similar characteristics, we expect positive economic impact with application of centrifugal TPE."

Clinical • HEOR

Clinical Application of Apheresis in Very Small Dogs Weighing <8 kg to Pediatric Patients. (PubMed, Ther Apher Dial) - "...Two dogs underwent large volume leukapheresis (LVL) to collect mononuclear cells in preparation for hematopoietic stem cell transplantation and two dogs underwent therapeutic plasma exchange (TPE) to treat an immune-mediated disease...All dogs completed the aphereses with no life-threatening adverse events (AE). We conclude that aphereses in very small dogs is feasible if close attention is paid to hemodynamic stability and citrate toxicity."

Clinical • Journal

CENTRIFUGAL VERSUS MEMBRANE THERAPEUTIC PLASMA EXCHANGE- SINGLE CENTER COST BENEFIT ANALYSIS IN THAILAND (ISPOR 2019) - "We demonstrated that centrifugal TPE had a better cost benefit ratio than membrane TPE."

Clinical • HEOR