Criterion for the inactivity of multiple sclerosis (NEDA-3) after 3 years of extracorporeal photopheresis

Extracorporeal photopheresis (extracorporeal photochemotherapy, extracorporeal photoimmunotherapy, or simply photopheresis) is a therapy based on exposure of peripheral blood leukocytes to ultraviolet radiation. A night incubation period is added to increase the efficiency of extracorporeal photopheresis. This modification of extracorporeal photopheresis is called «transimmunization». It induces the transformation of treated monocytes into cells expressing the phenotypic and functional features of dendritic antigen-presenting cells. Initially developed to treat cutaneous T-cell lymphoma, extracorporeal photopheresis has also proved effective in the treatment of graft-versus-host reactions, autoimmune diseases, and coronavirus infection, which is characterized by the development of autoimmune reactions. The purpose — to determine the effectiveness of transimmunization in patients with remitting multiple sclerosis using the NEDA-3 index for 3 years of treatment. Material and methods. 12 adult patients with remitting multiple sclerosis underwent transimmunization twice in a week every month for 6 months. Subsequently, the interval was increased each time by 1 month. Then the transimmunization was carried out twice a year. After 3 years from the start of treatment, the condition of patients was assessed using the criterion of «absence» of signs of disease activity (NEDA-3). The EDSS scale and MRI of the brain were used. Results. During the entire three-year treatment period, NEDA-3 was registered in 5 out of 12 patients (41,67%). Conclusion. Transimmunization (modification of extracorporeal photopheresis) had a positive effect on the condition of patients with remitting course of multiple sclerosis. The method can be used along with other methods of treating the disease to prevent disability of patients and improve their quality of life.