In a large, multicentre, placebo-controlled, Canadian study, the value of chronic plasmapheresis (PE) could not be proven. In this study, conducted over a two-year period, PE in association with oral cyclophosphamide and prednisone did not prevent progression of MS disability any more than placebo and sham PE. As discussed in Chapter 2, plasmapheresis may “rescue” (e.g., induce significant clinical improvement) up to 40 percent of relapsed MS and neuromyelitis optica patients who have failed to improve following treatment with high dose corticosteroids in the setting of a recent attack.

In the opinion of the Committee, the rationale behind plasmapheresis is plausible, but it has not been extensively tested so far, therefore must be regarded as experimental.