Efficacy of high-throughput leukocytapheresis for rheumatoid arthritis with a reduced response to infliximab.

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.
AuthorsYukinao Sakai, Saori Sakai, Tomoyuki Otsuka, Dai Ohno, Tsuneo Murasawa, Kazuo Munakata, Kyoichi Mizuno
JournalTherapeutic 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
PMID19527463 (Publication Type: Clinical Trial, Journal Article)
Chemical References
  • Antibodies, Monoclonal
  • Antirheumatic Agents
  • C-Reactive Protein
  • Infliximab
  • Adult
  • Antibodies, Monoclonal (therapeutic use)
  • Antirheumatic Agents (therapeutic use)
  • Arthritis, Rheumatoid (therapy)
  • Blood Sedimentation
  • C-Reactive Protein (metabolism)
  • Female
  • Humans
  • Infliximab
  • Leukapheresis (methods)
  • Male
  • Middle Aged
  • Severity of Illness Index
  • Time Factors
  • Treatment Outcome

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