Can Blood Adsorption Treatments Help With Multiple Sclerosis and Optic Neuritis?

During acute flare-ups of multiple sclerosis (MS), the primary treatment approach has traditionally been high-dose corticosteroid therapy. This method helps reduce inflammation and shorten the duration of the attack. However, for patients who cannot tolerate steroids due to medical contraindications, alternative treatments such as intravenous immunoglobulin (IVIG) are often considered.

Role of Blood Adsorption in MS

Blood adsorption therapy is less commonly used for multiple sclerosis, as the disease is primarily driven by cellular immunity rather than antibody-mediated mechanisms. Therefore, the effectiveness of this treatment for MS remains unclear and is not typically a first-line intervention.

Optic Neuritis and Blood Adsorption

In contrast, optic neuritis—often associated with neuromyelitis optica (NMO)—may respond more favorably to blood adsorption therapy, especially in severe cases. The initial treatment for optic neuritis during acute episodes is also high-dose steroid therapy. However, if symptoms persist or the patient does not respond well to steroids, blood adsorption can be a viable option.

How Blood Adsorption Works

Blood adsorption therapy typically involves processing 1 to 1.5 liters of blood per session, conducted over five consecutive days. This process filters out harmful antibodies that contribute to the autoimmune attack. Many patients experience noticeable improvement following this treatment, especially when conventional therapies fail.

Combining Treatments for Long-Term Management

While blood adsorption can provide acute relief, it's usually followed by long-term oral immunosuppressive therapy to prevent relapses. This dual approach helps manage both the immediate symptoms and the underlying immune response.

Challenges and Limitations

Despite its potential benefits, blood adsorption is not widely used in clinical practice. One major limitation is the requirement for large volumes of blood products, which are often in short supply. Additionally, the procedure places demands on the patient's cardiovascular and renal systems, making it unsuitable for everyone.

When Is Blood Adsorption Recommended?

This therapy is generally reserved for patients who are steroid-resistant or experiencing a particularly severe disease course. For these individuals, blood adsorption may offer a valuable treatment alternative when other options have failed.