Short and Long-Term Effects of Intravenous Methylprednisolone and Plasma Exchange Combination in NMOSD Attacks.

Introduction: Neuromyelitis optica spectrum disorder (NMOSD) is a debilitating autoimmune condition that, without timely intervention, can lead to severe disability or even death. Neuromyelitis optica spectrum disorder is an inflammatory disease of the central nervous system characterized by severe attacks such as optic neuritis and transverse myelitis. This study compared the short- and long-term effects of high-dose intravenous methylprednisolone (IVMP) and IVMP+plasma exchange (PLEX) treatment regimens. Methods: The study evaluated changes in patients' Expanded Disability Status Scale (EDSS) scores over a six-month follow-up period by using different ANOVA and linear regression methods. Results: Both IVMP and IVMP+PLEX treatments resulted in clinical improvement, with the addition of PLEX showing a more significant reduction in EDSS scores, particularly during the long follow-up period. Moreover, seropositive patients (AQP4/MOG-IgG positive) demonstrated a better response to treatment. Age and baseline EDSS scores were identified as key factors influencing post-treatment improvement. Conclusion: Our results suggest that the addition of PLEX to IVMP treatment might be suitable especially for severe NMOSD attacks.