Treatment of progressive systemic sclerosis by plasma exchange: long-term results in 40 patients.

Abstract

The efficacy of plasma exchanges (PE) during the course of scleroderma has only been investigated for short periods. The aim of this study was to follow patients over a long enough period to observe the course of the clinical and paraclinical symptoms in the short, medium, and long term. Forty patients, 24 women and 16 men, were treated by PE and observed for 1-3, 3-12 and over 12 months. Immunological, biological and clinical course and any undesirable side effects were evaluated using a detailed questionnaire. Concomitant therapies were reported and most frequently consisted of corticosteroids, colchicine, factor XIII or vasodilators (nifedipine, captopril). The therapeutic effectiveness of PE was assessed on the basis of improvements in cutaneous, digestive, joint, muscular, lung, cardiovascular and renal lesions. Our findings confirmed the effectiveness of short-term PE on scleroderma (52% of the patients improved during the first 3 months). However, this improvement was transient (5% improvement between 3 and 12 months and only 2.5% over 12 months) and limited to the cutaneous and muscular lesions. Thus, PE cannot be recommended for the treatment of progressive systemic sclerosis.

• Authors: L Guillevin, Z Amoura, P Merviel, J Pourrat, A Bussel, A Sobel, T Khuy, A Houssin, D Alcalay, P Stroumza
• Journal: The International journal of artificial organs (Int J Artif Organs) Vol. 13 Issue 2 Pg. 125-9 (Feb 1990) ISSN: 0391-3988 [Print] United States
• PMID: 2347656 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Child
• Female
• Humans
• Male
• Middle Aged
• Plasma Exchange
• Retrospective Studies
• Scleroderma, Systemic (mortality, pathology, therapy)
• Time Factors