PMID- 32664124
OWN - NLM
STAT- MEDLINE
DCOM- 20200803
LR  - 20240329
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 99
IP  - 28
DP  - 2020 Jul 10
TI  - Safety and efficacy of plasma exchange for the treatment of optic neuritis in 
      neuromyelitis optica spectrum disorders: A protocol for systematic review and 
      meta-analysis.
PG  - e21067
LID - 10.1097/MD.0000000000021067 [doi]
LID - e21067
AB  - BACKGROUND: Neuromyelitis optica spectrum disorders (NMOSD) is an inflammatory 
      and heterogeneous astrocyte disorder of the central nervous system (CNS), 
      concerned because of its high pathogenicity, high risk of recurrence, and poor 
      prognosis. Optic neuritis (ON) is the first manifestation in 30% to 50% of NMOSD 
      patients, and eventually involved optic nerve in 70% of patients. The idiopathic 
      ON associated with NMO is called NMO-associated ON(NMO-ON). There are substantial 
      costs to the countries and individuals associated with treatment of NMO-ON. 
      Intravenous corticosteroids (IVCSs), as the first-line therapy, leads to 
      unsatisfactory outcomes for NMO-ON and is associated with potential adverse 
      events (AEs). Emerging evidences have proved the important value and potential 
      prospect of plasma exchange (PLEX) in NMO-ON. Although PLEX is increasingly used 
      in NMO-ON, its therapeutic effect and safety are still controversial. There are 
      no systematic reviews yet that evaluated the effects of PLEX against other 
      therapies in patients with NMO-NO. It is therefore timely to perform a systematic 
      review to assess the efficacy and safety of PLEX on current research for its 
      potential use in clinical practice in treating NMO-ON. METHODS: The systematic 
      review will include all of the randomized controlled trials (RCT) on the efficacy 
      and safety of PLEX for NMO-ON. A relevant literature search by sensitive search 
      strategies was conducted using the following electronic databases from their 
      inception to November 30, 2019: PubMed, Web of Science, EMBASE, the Cochrane 
      Library, China National Knowledge Infrastructure (CNKI), Wanfang Database, China 
      Science and Technology Journal database (VIP) and CBM. We will also search 
      registers of clinical trials, potential gray literature, and conference 
      abstracts. There are no limits on language and publication status. The literature 
      screening, data extraction, and quality assessment will be conducted by 2 
      reviewers independently. The reporting quality and risk of bias will be assessed 
      by other 2 researchers. Best-corrected visual acuity (BCVA), annualized relapse 
      rate (ARR), the frequency and extent of adverse events (AEs) will be evaluated as 
      the primary outcome. The secondary outcomes will include expanded disability 
      status scales (EDSS), relapse-free rate, peri-papillary retinal nerve fibers 
      layer (pRNFL) or macular volume, visual electrophysiology examinations, standard 
      automated perimetry examinations, time to the next attack. Meta-analysis will be 
      performed using RevMan5.3 software provided by the Cochrane Collaboration and 
      Stata 12.0. RESULTS: This study will provide a comprehensive review based on 
      current evidence of PLEX treatment for NMO-ON in several aspects, including BCVA, 
      ARR, the frequency and extent of adverse events (AEs), EDSS, relapse-free rate, 
      etc. CONCLUSION:: The conclusion of this study will provide evidence to determine 
      whether PLEX is an effective and safe intervention for patients with NMO-ON. 
      ETHICS AND DISSEMINATION: It is not necessary to obtain ethical approval for this 
      study, given that this protocol is for a systematic review. The systematic review 
      will be published in a peer-reviewed journal, presented at conferences and will 
      be shared on social media platforms. PROSPERO REGISTRATION NUMBER: PROSPERO CRD 
      42020162585.
FAU - Han, Mengyu
AU  - Han M
AUID- ORCID: 0000-0003-2342-268
AD  - Graduate School, Beijing University of Chinese Medicine.
AD  - Department of Ophthalmology, China-Japan Friendship Hospital, Beijing, China.
FAU - Chen, You
AU  - Chen Y
AD  - Department of Ophthalmology, China-Japan Friendship Hospital, Beijing, China.
FAU - Nong, Luqi
AU  - Nong L
AD  - Graduate School, Beijing University of Chinese Medicine.
AD  - Department of Ophthalmology, China-Japan Friendship Hospital, Beijing, China.
FAU - Liu, Ziqiang
AU  - Liu Z
AD  - Graduate School, Beijing University of Chinese Medicine.
AD  - Department of Ophthalmology, China-Japan Friendship Hospital, Beijing, China.
FAU - Hao, Lu
AU  - Hao L
AD  - Science and education Department, Shenzhen Baoan Shiyan People's Hospital, 
      Shenzhen.
FAU - Wang, Zhijun
AU  - Wang Z
AD  - Department of Ophthalmology, China-Japan Friendship Hospital, Beijing, China.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - IM
MH  - Humans
MH  - Neuromyelitis Optica/therapy
MH  - Optic Neuritis/*therapy
MH  - Plasma Exchange/*methods
MH  - Recurrence
MH  - *Research Design
MH  - Severity of Illness Index
MH  - Visual Acuity
MH  - Meta-Analysis as Topic
MH  - Systematic Review as Topic
PMC - PMC7360232
COIS- The authors have no conflicts of interest to disclose.
EDAT- 2020/07/16 06:00
MHDA- 2020/08/04 06:00
PMCR- 2020/07/10
CRDT- 2020/07/16 06:00
PHST- 2020/07/16 06:00 [entrez]
PHST- 2020/07/16 06:00 [pubmed]
PHST- 2020/08/04 06:00 [medline]
PHST- 2020/07/10 00:00 [pmc-release]
AID - 00005792-202007100-00074 [pii]
AID - MD-D-20-05166 [pii]
AID - 10.1097/MD.0000000000021067 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2020 Jul 10;99(28):e21067. doi: 
      10.1097/MD.0000000000021067.