{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T00:57:08Z","timestamp":1791593828118,"version":"4.3.4"},"reference-count":16,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,6,8]],"date-time":"2024-06-08T00:00:00Z","timestamp":1717804800000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Apheresis"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Plasma exchange (PE) is considered a Category II option for the treatment of acute attacks and relapse cases of neuromyelitis optica spectrum disorder (NMOSD). However, neurologists are also considering intravenous immunoglobulins (IVIg) as an add\u2010on therapy for this disorder.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>The aim of this study is to evaluate the efficacy of PE in acute attacks of NMOSD when compared with IVIg, in terms of improvement in the Expanded disability status scale (EDSS) and activities of daily living (ADL) scale score and levels of anti\u2010Aquaporin P4 (AQP4) antibody in seropositive patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We enrolled 43 NMOSD patients in two groups: Group 1 (<jats:italic>n<\/jats:italic>\u2009=\u200929) received steroids and PE, and Group 2 (<jats:italic>n<\/jats:italic>\u2009=\u200914) received steroids with IVIg. The baseline EDSS and ADL scores were recorded and compared with scores at the end of therapy, 4\u2009weeks, and 3\u2009months after. Also, anti\u2010AQP4 antibody was measured at baseline and post\u2010therapy in seropositive patients of both groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We observed a significant difference in EDSS (<jats:italic>p<\/jats:italic>\u2009=\u20090.00) and ADL score (<jats:italic>p<\/jats:italic>\u2009=\u20090.00) at day 10 and 3\u2009months in both groups. However, no significant difference in EDSS, as well as ADL score from baseline (<jats:italic>p<\/jats:italic>\u2009=\u20090.83; <jats:italic>p<\/jats:italic>\u2009=\u20090.25) to 3\u2009months (<jats:italic>p<\/jats:italic>\u2009=\u20090.85; <jats:italic>p<\/jats:italic>\u2009=\u20090.19), was observed when delta change of score at 3\u2009months was compared across the two groups (<jats:italic>p<\/jats:italic>\u2009=\u20090.39; <jats:italic>p<\/jats:italic>\u2009=\u20090.52). We observed improved visual acuity in both groups with mild improvement in findings of magnetic resonance imaging at 3\u2009months. We observed a significant decline in AQP4 antibody concentration (at day 10) in group 1 seropositive patients (<jats:italic>p<\/jats:italic>\u2009=\u20090.013) with improved EDSS (<jats:italic>p<\/jats:italic>\u2009=\u20090.027) and ADL scores (<jats:italic>p<\/jats:italic>\u2009=\u20090.026) of these patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>PE should be considered as a choice of an add\u2010on therapy in anti\u2010AQP4 antibody\u2010positive NMOSD patients compared with IVIg as it is more effective in reducing antibody concentrations.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jca.22129","type":"journal-article","created":{"date-parts":[[2024,6,8]],"date-time":"2024-06-08T08:44:23Z","timestamp":1717836263000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Comparison of efficacy of plasma exchange versus intravenous immunoglobulin as an add\u2010on therapy in acute attacks of neuromyelitis optica spectrum disorder"],"prefix":"10.1002","volume":"39","author":[{"given":"Garima","family":"Siwach","sequence":"first","affiliation":[{"name":"Department of Transfusion Medicine Post Graduate Institute of Medical Education and Research (PGIMER)  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7101-0853","authenticated-orcid":false,"given":"Rekha","family":"Hans","sequence":"additional","affiliation":[{"name":"Department of Transfusion Medicine Post Graduate Institute of Medical Education and Research (PGIMER)  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aastha","family":"Takkar","sequence":"additional","affiliation":[{"name":"Department of Neurology Post Graduate Institute of Medical Education and Research (PGIMER)  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chirag Kamal","family":"Ahuja","sequence":"additional","affiliation":[{"name":"Department of Radiodiagnosis and Imaging Post Graduate Institute of Medical Education and Research (PGIMER)  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0961-0369","authenticated-orcid":false,"given":"Divjot Singh","family":"Lamba","sequence":"additional","affiliation":[{"name":"Department of Transfusion Medicine Post Graduate Institute of Medical Education and Research (PGIMER)  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivek","family":"Lal","sequence":"additional","affiliation":[{"name":"Department of Neurology Post Graduate Institute of Medical Education and Research (PGIMER)  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ratti Ram","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Transfusion Medicine Post Graduate Institute of Medical Education and Research (PGIMER)  Chandigarh 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