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ORIGINAL RESEARCH
Comparison of extracorporeal photopheresis and glatiramer acetate efficacy in the treatment of multiple sclerosis
Vladimirsky Moscow Regional Research and Clinical Institute, Moscow, Russia
Correspondence should be addressed: Olga P. Sidorova
Shhepkina 61/2, Moscow, 129110, Russia; sidorovaop2019@mail
Author contribution: Kildyushevsky AV — study planning, literature review, extracorporeal photopheresis (transimmunization), data interpretation, manuscript writing; Kotov SV — study planning, literature review, data interpretation, manuscript writing; Sidorova OP — literature review, data acquisition and interpretation, patient assessment using EDSS, manuscript writing; Borodin AV — literature review, data acquisition and interpretation, patient assessment using EDSS, manuscript writing; Bunak MS — literature review, data acquisition and interpretation, MRI, manuscript writing.
Compliance with ethical standards: the study was approved by the Ethics Committee (protocol No. 16 dated 26 November 2020); the informed consent to participation in the study was submitted by all subjects.
Multiple sclerosis is an autoimmune disorder, the development of which involves humoral and cellular immunity. The disease-modifying drugs (DMDs) for multiple sclerosis slow down the disease progression, but the therapy prescribed is not always well tolerated by patients; allergy and other side effects are possible. In this regard, the development of new methods, including non-pharmacological ones, is relevant. These methods include extracorporeal photopheresis involving UV exposure of peripheral blood lymphocytes and its modification — transimmunization (involving incubation of lymphocytes after UV exposure). The study aimed to compare and within a year assess the transimmunization and glatiramer acetate efficacy in patients with relapsing-remitting multiple sclerosis. A total of 19 adult patients with relapsing-remitting multiple sclerosis, who had been prescribed transimmunization, were assessed. Patients over the age of 18, who did not receive treatment by other methods (DMDs for multiple sclerosis, etc.), were included in the study. The comparison group consisted of 48 adult patients with relapsing-remitting multiple sclerosis, who were prescribed subcutaneous glatiramer acetate 20 mg daily. Clinical assessment was performed using EDSS. Brain and spinal cord MRI was performed in the 3.0 and 1.5 T scanners. When performing transimmunization, the decrease in the median overall EDSS score from 2 to 1.5 points was reported. In the comparison group of patients receiving glatiramer acetate, the median EDSS score changed from 1.75 to 2 points. Therefore, transimmunization is comparable with first-line DMDs for multiple sclerosis and can be used to stabilize the disease course.
Keywords: multiple sclerosis, autoimmune disease, extracorporeal photopheresis, transimmunization, glatiramer acetate