Consensus recommendation on the use of therapeutic plasma exchange for adult neurological diseases in Southeast Asia from the Southeast Asia therapeutic plasma exchange consortium

Therapeutic plasma exchange (TPE) is an effective and affordable treatment option in most parts of Southeast Asia (SEA). In 2018, the SEA TPE Consortium (SEATPEC) was established, consisting of regional neurologists working to improve outcome of various autoimmune neurological diseases. We proposed...

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Autores principales:	Fu Liong Hiew, Win Min Thit, Mathew Alexander, Umapathi Thirugnanam, Sasitorn Siritho, Kevin Tan, Seinn Mya Mya Aye, Ohnmar Ohnmar, Riwanti Estiasari, Norazieda Yassin, Paul Matthew Pasco, Say Saysavath Keosodsay, Hoang Tien Trong Nghia, MD Badrul Islam, Sing Keat Wong, Shirley Lee, Anupam Chhabra, Shanthi Viswanathan
Formato:	article
Lenguaje:	EN
Publicado:	SAGE Publishing 2021
Materias:	Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/fa7eb3a10c964520b5fef689050b9dc4
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spelling	oai:doaj.org-article:fa7eb3a10c964520b5fef689050b9dc42021-12-01T22:33:18ZConsensus recommendation on the use of therapeutic plasma exchange for adult neurological diseases in Southeast Asia from the Southeast Asia therapeutic plasma exchange consortium1179-573510.1177/11795735211057314https://doaj.org/article/fa7eb3a10c964520b5fef689050b9dc42021-11-01T00:00:00Zhttps://doi.org/10.1177/11795735211057314https://doaj.org/toc/1179-5735Therapeutic plasma exchange (TPE) is an effective and affordable treatment option in most parts of Southeast Asia (SEA). In 2018, the SEA TPE Consortium (SEATPEC) was established, consisting of regional neurologists working to improve outcome of various autoimmune neurological diseases. We proposed an immunotherapeutic guideline prioritizing TPE for this region. We reviewed disease burden, evidence-based treatment options, and major guidelines for common autoimmune neurological disorders seen in SEA. A modified treatment algorithm based on consensus agreement by key-opinion leaders was proposed. Autoimmune antibody diagnostic testing through collaboration with accredited laboratories was established. Choice of first-line immunotherapies (IVIg/corticosteroid/TPE) is based on available evidence, clinicians’ experience, contraindications, local availability, and affordability. TPE could be chosen as first-line therapy for GBS, CIDP, MG (acute/short term), IgG, A paraproteinemic neuropathy, and NMDAR encephalitis. Treatment is stopped for acute monophasic conditions such as GBS and ADEM following satisfactory outcome. For chronic immune disorders, a therapy taper or long-term maintenance therapy is recommended depending on the defined clinical state. TPE as second-line treatment is indicated for IVIg or corticosteroids refractory cases of ADEM, NMOSD (acute), MG, and NMDAR/LGI1/CASPR2/Hashimoto’s encephalitis. With better diagnosis, treatment initiation with TPE is a sustainable and effective immunotherapy for autoimmune neurological diseases in SEA.Fu Liong HiewWin Min ThitMathew AlexanderUmapathi ThirugnanamSasitorn SirithoKevin TanSeinn Mya Mya AyeOhnmar OhnmarRiwanti EstiasariNorazieda YassinPaul Matthew PascoSay Saysavath KeosodsayHoang Tien Trong NghiaMD Badrul IslamSing Keat WongShirley LeeAnupam ChhabraShanthi ViswanathanSAGE PublishingarticleNeurology. Diseases of the nervous systemRC346-429ENJournal of Central Nervous System Disease, Vol 13 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neurology. Diseases of the nervous system RC346-429
spellingShingle	Neurology. Diseases of the nervous system RC346-429 Fu Liong Hiew Win Min Thit Mathew Alexander Umapathi Thirugnanam Sasitorn Siritho Kevin Tan Seinn Mya Mya Aye Ohnmar Ohnmar Riwanti Estiasari Norazieda Yassin Paul Matthew Pasco Say Saysavath Keosodsay Hoang Tien Trong Nghia MD Badrul Islam Sing Keat Wong Shirley Lee Anupam Chhabra Shanthi Viswanathan Consensus recommendation on the use of therapeutic plasma exchange for adult neurological diseases in Southeast Asia from the Southeast Asia therapeutic plasma exchange consortium
description	Therapeutic plasma exchange (TPE) is an effective and affordable treatment option in most parts of Southeast Asia (SEA). In 2018, the SEA TPE Consortium (SEATPEC) was established, consisting of regional neurologists working to improve outcome of various autoimmune neurological diseases. We proposed an immunotherapeutic guideline prioritizing TPE for this region. We reviewed disease burden, evidence-based treatment options, and major guidelines for common autoimmune neurological disorders seen in SEA. A modified treatment algorithm based on consensus agreement by key-opinion leaders was proposed. Autoimmune antibody diagnostic testing through collaboration with accredited laboratories was established. Choice of first-line immunotherapies (IVIg/corticosteroid/TPE) is based on available evidence, clinicians’ experience, contraindications, local availability, and affordability. TPE could be chosen as first-line therapy for GBS, CIDP, MG (acute/short term), IgG, A paraproteinemic neuropathy, and NMDAR encephalitis. Treatment is stopped for acute monophasic conditions such as GBS and ADEM following satisfactory outcome. For chronic immune disorders, a therapy taper or long-term maintenance therapy is recommended depending on the defined clinical state. TPE as second-line treatment is indicated for IVIg or corticosteroids refractory cases of ADEM, NMOSD (acute), MG, and NMDAR/LGI1/CASPR2/Hashimoto’s encephalitis. With better diagnosis, treatment initiation with TPE is a sustainable and effective immunotherapy for autoimmune neurological diseases in SEA.
format	article
author	Fu Liong Hiew Win Min Thit Mathew Alexander Umapathi Thirugnanam Sasitorn Siritho Kevin Tan Seinn Mya Mya Aye Ohnmar Ohnmar Riwanti Estiasari Norazieda Yassin Paul Matthew Pasco Say Saysavath Keosodsay Hoang Tien Trong Nghia MD Badrul Islam Sing Keat Wong Shirley Lee Anupam Chhabra Shanthi Viswanathan
author_facet	Fu Liong Hiew Win Min Thit Mathew Alexander Umapathi Thirugnanam Sasitorn Siritho Kevin Tan Seinn Mya Mya Aye Ohnmar Ohnmar Riwanti Estiasari Norazieda Yassin Paul Matthew Pasco Say Saysavath Keosodsay Hoang Tien Trong Nghia MD Badrul Islam Sing Keat Wong Shirley Lee Anupam Chhabra Shanthi Viswanathan
author_sort	Fu Liong Hiew
title	Consensus recommendation on the use of therapeutic plasma exchange for adult neurological diseases in Southeast Asia from the Southeast Asia therapeutic plasma exchange consortium
title_short	Consensus recommendation on the use of therapeutic plasma exchange for adult neurological diseases in Southeast Asia from the Southeast Asia therapeutic plasma exchange consortium
title_full	Consensus recommendation on the use of therapeutic plasma exchange for adult neurological diseases in Southeast Asia from the Southeast Asia therapeutic plasma exchange consortium
title_fullStr	Consensus recommendation on the use of therapeutic plasma exchange for adult neurological diseases in Southeast Asia from the Southeast Asia therapeutic plasma exchange consortium
title_full_unstemmed	Consensus recommendation on the use of therapeutic plasma exchange for adult neurological diseases in Southeast Asia from the Southeast Asia therapeutic plasma exchange consortium
title_sort	consensus recommendation on the use of therapeutic plasma exchange for adult neurological diseases in southeast asia from the southeast asia therapeutic plasma exchange consortium
publisher	SAGE Publishing
publishDate	2021
url	https://doaj.org/article/fa7eb3a10c964520b5fef689050b9dc4
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Consensus recommendation on the use of therapeutic plasma exchange for adult neurological diseases in Southeast Asia from the Southeast Asia therapeutic plasma exchange consortium

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