Filtration Leukocytapheresis Therapy in the Treatment of Rheumatoid Arthritis Patients Resistant To or Failed with Methotrexate

Abstract

Filtration leukocytapheresis (LCP) is a treatment for abnormal autoimmune states, which removes responsible leukocytes from the peripheral blood. To examine the efficacy of LCP therapy in the treatment of rheumatoid arthritis (RA), nine patients were selected, who were either resistant to methotrexate, or failed with methotrexate due to drug ineffectiveness or adverse side effects. For these patients, LCP therapy was performed once a week for five weeks. After five LCP treatments, the patients were observed for 12 weeks, to test the efficacy of the treatment. The definition of improvement given by the American College of Rheumatology (ACR core set) was used for efficacy evaluation of LCP therapy. As the result, 77.8% of the patients showed an ACR 20% response and 44.4% of the patients showed an ACR 50% response. With improvement of joint symptoms, IL-6 was significantly decreased at 8 weeks and 12 weeks after the treatment. The expression of adhesion molecules CD11a, CD11b, and CD18 on granulocytes decreased directly after the LCP treatment. No adverse side effect was monitored during the study period. These results indicates that LCP treatment is a useful treatment for RA patients who were resistant to methotrexate, or failed with methotrexate due to ineffectiveness or side effects of the drug.

Therapeutic Efficacy of Leukocytapheresis in a Pregnant Woman with Refractory Adult-onset Still's Disease

“…Depleting excess and activated leukocytes by intensive LCAP treatment may alleviate inflammation and promote the remission of AOSD. The LCAP treatment corrected the Th1/Th2 cytokine balance in the patients with RA (15,21). Maternal tolerance toward fetal alloantigens is explained by predominant Th2-type immunity during pregnancy.…”

Improved response to infliximab after leukocytapheresis in a patent with rheumatoid arthritis

“…[1][2][3] No major adverse effects have been observed so far. Kempe et al 3 reported that improvements in symptoms appeared slowly, but persisted until 12 weeks after the LCAP therapy. A slow response was also observed in our case.…”

“…The effectiveness of the LCAP therapy has been reported in the past decade. [1][2][3] Therefore, LCAP is sometimes indicated for RA in Japan. Herein, we report a case of effective treatment of LCAP in an acquired IFM-resistant patient with RA whose response to IFM was recovered after LCAP.…”

Refrakter Romatoid Artrit Tedavisinde Terapotik Aferez Uygulamaları

“…DMARD'lar ya da biyolojik ajanlara iyi yanıt vermeyen RA'li hastalarda etkili olduğu bildirilmiştir 18 . Vücut ağırlığı başına daha yüksek bir kan hacmi (100 ml/kg) işleyebilen A kolonu (CS-180S) veya 60 ml/kg kanı işleyebilen konvansiyonel kolonu (CS-100) son zamanlarda geliştirilmiştir.…”