{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T20:49:21Z","timestamp":1787863761833,"version":"build-2784847793"},"reference-count":28,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2020,9,21]],"date-time":"2020-09-21T00:00:00Z","timestamp":1600646400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Transl Neurol"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To conduct systematic review and meta\u2010analysis for the efficacy of therapeutic plasma exchange (TPE) for neuromyelitis optica spectrum disorder (NMOSD) with an acute attack.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Systematic review was performed using EMBASE and OVID\/Medline database. The eligible studies must be the studies of NMOSD patients treated with TPE during the acute phase. They must report treatment outcomes using either Expanded Disability Status Scale (EDSS) or visual acuity (VA) before and after the therapy. Pooled mean difference (MD) was then calculated by combining MDs of each study using the random\u2010effects model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifteen studies were identified; eleven with 241 NMOSD patients reported EDSS outcome and four studies with 103 NMOSD reported visual outcomes. The meta\u2010analysis demonstrated a significantly decreased in EDSS after TPE treatment for NMOSD with an acute attack with the pooled MD of 0.83 (95% CI, 0.26\u20131.40; I<jats:sup>2<\/jats:sup> 69%) comparing pretreatment to immediate posttreatment and 2.13 (95% CI, 1.55\u20132.70; I<jats:sup>2<\/jats:sup> 31%) comparing pretreatment to posttreatment at 6\u00a0months to 1\u2010year follow\u2010up. Unfortunately, only one of the four studies evaluating visual outcomes reported standard deviation in association with mean LogMAR; therefore, the meta\u2010analysis cannot be conducted. Nonetheless, all studies consistently demonstrated the benefit of TPE with improved VA and\/or LogMAR after treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>This systematic review and meta\u2010analysis showed the benefit of TPE during the NMOSD attack with a significantly improved disability status immediately after treatment and during follow\u2010up.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acn3.51203","type":"journal-article","created":{"date-parts":[[2020,9,21]],"date-time":"2020-09-21T21:19:36Z","timestamp":1600723176000},"page":"2094-2102","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Effect of plasma exchange in neuromyelitis optica spectrum disorder: A systematic review and 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