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October 1983

Plasma Exchange in Acute Multiple Sclerosis: Design of a Cooperative Study

Author Affiliations

From the Multiple Sclerosis Clinical and Research Unit, Department of Medicine, Division of Neurology, Brigham & Women's Hospital and the Department of Neuroscience, Children's Hospital Medical Center, Boston.

Arch Neurol. 1983;40(11):691-692. doi:10.1001/archneur.1983.04050100031010

In 1979, a number of investigators began preliminary studies of plasma exchange in patients with multiple sclerosis (MS).1-3 The basic rationale was that MS is an autoimmune disease4 and plasma exchange, by removing putative autoantibodies or other immunoactive serum factors, might have a beneficial effect. Prior studies of immunotherapy in MS, using a variety of medical approaches, had suggested a potential benefit to such therapy.5 The application of plasma exchange to MS was also based on the success of plasma exchange in myasthenia gravis,6 another autoimmune disease of the nervous system, even though the immune pathogenesis of MS remains undefined.

Within the next year, a large number of investigators began treating MS with various plasma exchange regimens. The regimens included both plasma exchange alone and plasma exchange together with immunosuppressive agents and were administered to patients at a variety of clinical stages of MS. Virtually