| Abstract | Infliximab (INF), a tumor necrosis factor-alpha (TNF-alpha) inhibitor, is an effective drug for patients with rheumatoid arthritis (RA). However, some patients receive no clinical benefit, or the agents gradually lose their effect. Five sessions of high-throughput leukocytapheresis (LCAP) were given at a frequency of once a week using a Cellsorba CS-180S to four patients with a reduced response to INF. The clinical response to LCAP was evaluated using the 28-joint disease activity score with C-reactive protein (DAS28-CRP) and with the erythrocyte sedimentation rate (DAS28-ESR). DAS28-CRP decreased significantly from 5.8 +/- 0.6 before LCAP to 3.9 +/- 0.7 (P = 0.0182) at 1-2 weeks after completion of five sessions of LCAP, and DAS28-ESR decreased significantly from 6.4 +/- 0.6 to 4.6 +/- 0.5 (P = 0.0267). Moreover, all patients had a moderate response according to the European League Against Rheumatism (EULAR) response criteria. The effect of LCAP continued for at least 6 months after its completion in all patients, with no changes in any of their concomitant drugs, and the effect was maintained for at least 1 year in three of the four patients. These results indicate that LCAP is a useful treatment for RA patients with a reduced response to INF. |
| Authors | Yukinao Sakai, Saori Sakai, Tomoyuki Otsuka, Dai Ohno, Tsuneo Murasawa, Kazuo Munakata, Kyoichi Mizuno
(Affiliation: Department of Internal Medicine, Nippon Medical School Musashikosugi Hospital, Kanagawa, Japan. y-sakai at nms.ac.jp)
|
| Journal | Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy
(Ther Apher Dial)
Vol. 13
Issue 3
Pg. 179-85
(Jun 2009)
ISSN: 1744-9987 [Electronic] Australia |
| PMID | 19527463
(Publication Type: Clinical Trial, Journal Article)
|
| Chemical References |
- Antibodies, Monoclonal
- Antirheumatic Agents
- infliximab
- C-Reactive Protein
|
| Topics |
- Adult
- Antibodies, Monoclonal
(therapeutic use)
- Antirheumatic Agents
(therapeutic use)
- Arthritis, Rheumatoid
(therapy)
- Blood Sedimentation
- C-Reactive Protein
(metabolism)
- Female
- Humans
- Leukapheresis
(methods)
- Male
- Middle Aged
- Severity of Illness Index
- Time Factors
- Treatment Outcome
|
