This is the protocol for a review and there is no abstract. The objectives are as follows:
The objective of this review is to evaluate the efficacy and safety of plasmapheresis (alone or in combination with other immunomodulating treatment) in patients with relapsing-remitting or secondary progressive or primary progressive MS.
We want to evaluate the principal hypothesis that plasmapheresis, performed during the relapses, can:
1. Improve disability after a relapse;
2. Reduce the number of relapses during the follow-up;
3. Prevent disability progression on long observation.
Moreover, we want to evaluate whether plasmapheresis performed during the progressive course can delay disability progression during the follow-up of patients with primary of secondary progressive MS.
The secondary aims are to evaluate if the effect of the treatment is different according to:
1. The type of course of MS;
2. The duration of the disease prior the beginning of the treatment with plasma exchange.