Effects of Cascade Apheresis in Patients with Psoriasis and Psoriatic Arthropathy

Jørstad, Størker; Bergh, Kåre; Iversen, Ole‐Jan; Johnsson, M.; Lysvand, Hilde; Fjærtoft, Hild; Widerøe, Tor-Erik; Rødsjø, J.Å.; Næss, T.; Bolsø, M.; Kværnes, S.

doi:10.1159/000014311

Cited by 8 publications

(4 citation statements)

References 26 publications

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“…From these results, it is concluded that CIC may play a more significant role in psoriatic arthropathy than in skin manifestations, and TPE may be beneficial in patients not responding to conventional therapy. 99 Other authors reported their results with treatment of extracorporeal photochemotherapy and lymphocytapheresis. But the skin lesions did not respond to photopheresis.…”

Section: Methodsmentioning

confidence: 99%

“…Jorstadt et al treated eight patients with psoriasis with skin scales and seven with disabling psoriatic arthritis with cascade filtration for 2 weeks. 99 There was a large drop in the levels of circulating immune complexes due to treatment, and the removal of circulating immune complex (CIC) was followed by reduced inflammatory activity in skin lesions and joints as evaluated by pain, morning stiffness, grip strength, plaque score, and Psoriasis Area Severity Index (PASI) index. However, there was no correlation between the level of CIC, disease activity, or treatment response.…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Therapeutic Apheresis in Dermatological Diseases

Bambauer¹,

Burgard²,

Schiel³

2015

Clinical Medicine Insights: Therapeutics

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Since the mid-1970s, membrane modules became available and plasma separation techniques have gained importance. Therapeutic apheresis (TA) has been successfully introduced in a variety of autoantibody-mediated diseases. In dermatology, TA is increasingly applied as a support treatment for severe and/or refractory autoimmune bullous diseases. All autoimmune disease are characterized by autoantibodies mediated against structural proteins of the skin and/or mucous membranes. Autoimmune blistering diseases have a high morbidity and mortality. These diseases include pemphigus vulgaris and bullous pemphigoid among others. Drug-induced pemphigus and other forms, such as dermatitis herpetiformis, herpes gestationis, scleroderma, pyoderma gangrenosum, epidermal necrolysis, Behcet disease, psoriasis vulgaris, Henoch-Schönlein purpura, and porphyria cutanea tarda, are also mentioned. Pathogenetical aspects of autoantibodies in these diseases are clearly demonstrated. TA has been shown to effectively remove the autoantibodies from blood and lead to rapid clinical improvement.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Therapeutic Apheresis in Dermatological Diseases

Bambauer¹,

Burgard²,

Schiel³

2015

Clinical Medicine Insights: Therapeutics

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“…Fundamental for its immunopathogenic mechanism is the secretion of type 1 (Th 1) cytokines by T cells and their activation [27]. TPE may be beneficial in patients with psoriatic arthropathy and not responding to conventional therapy [28]. However, blocking TNF-α by infliximab or etanercept has shown particular promise, especially in the management of psoriasis.…”

Section: Avens Publishing Groupmentioning

confidence: 99%

Therapeutic Apheresis and/or Monoclonal Antibodies in Dermatological Diseases

2021

J Clin Investig Dermatol

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Inviting Innovations in autoantibody titers, antikeratinocyte cell surface antibodies, and anti-desmoglein-3 correlated with clinical response in a number of patients [2,[6][7][8][9]. The antiepidermal antibodies, which usually belong to the IgG category, can be easily eliminated with TPE [6,7].Bullous pemphigoid (BP) is another form of subepidermal blistering pemphigus; BP is rare. BP frequently involves a premonitory stage with pruritic urticarial erythema and eczematous lesions followed by the classical bullous stage with tense blisters, erosions, and crusts [8]. BP is a chronic dermatosis often associated with acute exacerbations, with the formation of bullae blisters usually on the inflamed skin, subepidermal blister formation, and antibodies against the epidermal basal membrane. Thus, BP can also occur in combination with other autoimmune disorders.The course of this pemphigus disorder is not as dramatic as other forms of the disease, with good response to high-potency corticosteroids, which are usually combined with dapsone, doxycycline, methotrexate, or azathioprine in usually dosages [3]. BP has an annual incidence of about 13-42 new cases per 1 million in central Europe and the United Kingdom [9,10]. Only a few cases have been treated with TPE up to noe [11]. After 3 to 5 treatments in one week, we could see if TPE or IA can decrease the antibody titer. In very low antibody titers, the frequency of the treatments can decrease, too. Because the pathogenic relevance of autoantibodies was clearly demonstrated in the majority of autoimmune bullous diseases, removal of autoantibodies, therefore, TPE is indicated. IA and rituximab have been establisheds additional therapeutic options [12]. D-Penicillamine induced pemphigus, steroid-resistant pemphigus, is a foliaceustype disease with high lethality and mortality rate, which can occur as a side effect in long-term penicillamine therapy, which is a particular indication for TPE [13]. Only case reports of D-penicillamine"-induced pemphigus" treated successfully with TA were reported in combination with immunosuppresion. IA is the most specific therapeutic option, in which only the pathogenic IgG is depleted in the patient's plasma. Three to 5 treatments of TPE or IA and immunosuppressive drugs in one or two weeks are necessary to an improvement of the disease. A combination of IA and rituximab showed rapid and long-lasting response of concomitant im-

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Guidelines on the Use of Therapeutic Apheresis in Clinical Practice—Evidence‐Based Approach from the Writing Committee of the American Society for Apheresis: The Sixth Special Issue

Schwartz

Winters

Padmanabhan

et al. 2013

J of Clinical Apheresis

562

769

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The American Society for Apheresis (ASFA) JCA Special Issue Writing Committee is charged with reviewing, updating and categorizating indications for therapeutic apheresis. Beginning with the 2007 ASFA Special Issue (Fourth Edition), the committee has incorporated systematic review and evidence-based approach in the grading and categorization of indications. This Sixth Edition of the ASFA Special Issue has further improved the process of using evidence-based medicine in the recommendations by consistently applying the category and GRADE system definitions, but eliminating the "level of evidence" criteria (from the University HealthCare Consortium) utilized in prior editions given redundancy between GRADE and University HealthCare Consortium systems. The general layout and concept of a fact sheet that was utilized in the Fourth and Fifth Editions, has been largely maintained in this edition. Each fact sheet succinctly summarizes the evidence for the use of therapeutic apheresis in a specific disease entity. This article consists of 78 fact sheets (increased from 2010) for therapeutic indications in ASFA categories I through IV, with many diseases categorized having multiple clinical presentations/situations which are individually graded and categorized.

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Effects of Cascade Apheresis in Patients with Psoriasis and Psoriatic Arthropathy

Cited by 8 publications

References 26 publications

Therapeutic Apheresis in Dermatological Diseases

Therapeutic Apheresis in Dermatological Diseases

Therapeutic Apheresis and/or Monoclonal Antibodies in Dermatological Diseases

Guidelines on the Use of Therapeutic Apheresis in Clinical Practice—Evidence‐Based Approach from the Writing Committee of the American Society for Apheresis: The Sixth Special Issue

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