IMMUNOADSORPTION THERAPY FOR MYASTHENIA-GRAVIS

The results of a multicentre trial were analysed to evaluate the effic acy of immunoadsorption therapy for severe generalised myasthenia grav is. Twenty patients with myasthenia gravis who mere concurrently recei ving high dose prednisolone and azathioprine therapy were treated with an affinity-type adsorbent, using tryptophan-linked polyvinyl alcohol gel (IM-TR), according to a standardised treatment protocol. The 20 p atients received five adsorption treatments within a period of 10 days . In 11, pronounced improvement of myasthenic weakness was seen and lo ng-term remission was maintained. The treatment was especially effecti ve in patients with thymic hyperplasia. Circulating acetylcholine rece ptor (AChR) antibodies were reduced by about 60% by treating one plasm a volume. There was no difference in the rate of removal of the AChR a ntibodies between patients with thymic hyperplasia and patients with t hymoma. No serious complications occurred during 100 procedures. It wa s concluded that the immunoadsorption therapy with IM-TR is useful in controlling symptoms in patients with severe myasthenia gravis who are otherwise unresponsive.