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Plasma Exchange
A Clear Road to Results for MG and GBS Patients
Overview MG GBS How It Works Safety Resources References

MG: A Clear Road to Recovery

Although clinical trials suggest that intravenous immunoglobulin (IVIg) and plasma exchange are equally effective in the treatment of impending or manifest myasthenic crisis, expert consensus suggests that plasma exchange is more effective and works more quickly. –Sanders, 2016

Introducing Plasma Exchange As a First-Line Therapy for MG

The Spectra Optia system is the first therapeutic apheresis system indicated to treat myasthenia gravis (MG). Using plasma exchange on the Spectra Optia system results in a fast road to recovery for majority of MG patients by delivering a rapid clinical response.

Evidence-Based Guidance for Plasma Exchange in MG


EFNS 20101 Cochrane 20132 ASFA 20163 MGFA consensus 20164
  • Level A for acute exacerbation
  • Level B prethymectomy
  • Moderate–severe (Grade II)
  • Prethymectomy (Grade III)
  • Category I
  • Moderate–severe (Grade 1B)
  • Prethymectomy (Grade 1C)
  • Short-term treatment in myasthenic crisis
  • Prethymectomy
  • Refractory MG
  • Prior to corticosteroids

1Elovaara I, et al. Eur J Neurol. 2008; 15:893-908. 2Raphaël JC, et al. Cochrane Database Syst Rev. 2012(7). 3Schwartz J, et al. J Clin Apher. 2016; 31(3):149-162. 4Sanders DB, et al. Neurology. 2016; 87(4):419-425.

Speed to Response for MG Patients

In choosing a therapy, seeing results as quickly as possible is critical in order to hasten recovery or maintain optimal symptom management. Plasma exchange rapidly removes disease mediators, essentially quieting the immune response and relieving symptoms. (Derksen, 1984) For MG crisis, this means hastening recovery, such as enabling the patient to come off the ventilator faster and achieve quicker functional outcome improvement. (Quereshi et al., 1999)

Time of Clinical Effect of Therapies for Myasthenia Gravis
Treatment Time to Clinical Effect
Pyridostigmine 10–15 minutes
Plasma exchange 1–14 days
IVIg 1–4 weeks
Prednisone 2–8 weeks
Mycophenolate mofetil 2–6 months
Cyclosporine 2–6 months
Azathioprine 3–18 months

Saperstein D, Barohn R. Management of myasthenia gravis. Semin Neurology. 2004;24(1):41-48.

Speed to Recovery for MG Patients

Studies show that plasma exchange treatment provides significant clinical benefits when used as a stand-alone therapy for MG patients, including generalized, refractory, crisis and MuSK+. (Sanders, 2016)

MG Results

MG MuSK+ Results

Multiple studies and expert opinion support that plasma exchange has superior efficacy over IVIg for MuSK+ MG.
(Guptil et al., 2011) (Pasnoor et al., 2010) (Vincent, 2008)

The international consensus guidance for management of myasthenia gravis states, "MuSK-MG responds well to PLEX, while IVIg seems to be less effective." (Sanders et al., 2016)

Retrospective chart review of 53 MuSK-Ab-positive MG patients at nine university-based centers in the U.S. showed that 51 percent of patients improved with plasma exchange versus 20 percent with IVIg. (Pasnoor et al., 2010)

In a 2011 review of 110 MuSK- MG patients from two large clinics in Italy and the U.S., plasma exchange produced improvement in 93 percent of patients, compared with only 61 percent who improved after IVIg. (Guptil et al., 2011)

Long-term outcome (3 years) was very favorable in 58 percent of patients who achieved remission and/or minimal manifestation status. (Pasnoor et al., 2010)

Did You Know?

Plasma exchange can be performed peripherally

Get the facts

Safety Information


  • No known contraindications for the system's use, except for those associated with all automated apheresis systems
  • The infusion of certain solutions and replacement fluids may be contraindicated in some patients

Possible patient reactions

  • Anxiety, headache, light-headedness, digital and/or facial paresthesia, fever, chills, hematoma, hyperventilation, nausea and vomiting, syncope (fainting), urticaria, hypotension and allergic reactions

Reactions to transfused blood products can include1

  • Fever, circulatory overload, shock, allergic reactions, alloimmunization, graft-versus-host disease and transmission of infection

Restricted to prescription use only

  • Operators must be familiar with the system's operating instructions
  • Procedures must be performed by qualified medical personnel
  • A supervisory practitioner may supervise from a physician office or other nonhospital space that is not officially part of the hospital campus as long as he or she remains immediately available2

1AABB (ed.), et al., Circular of Information for the Use of Human Blood and Blood Components. 2006, tenth edition, Council of Europe Publishing, Seattle, WA.

2American Society for Apheresis. Guidelines for therapeutic apheresis clinical privileges. J Clin Apher. 2007;22(3):181-182.

Download MG Clinical Summary Sheet
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International Content. Approved labeling, indications and instructions may vary by country. Reference the Instructions for Use labeling for a complete listing of indications, warnings and precautions.


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