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

Azuma, Teruhisa; Ishimaru, Hiroyasu; Hatta, Kazuhiro; Kori, Y

doi:10.1007/s10165-007-0576-9

Mod Rheumatol

2007

DOI: 10.1007/s10165-007-0576-9

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

Teruhisa Azuma¹,

Hiroyasu Ishimaru²,

Kazuhiro Hatta³

et al.

Abstract: This is the first report on effective leukocytapheresis (LCAP) in an acquired infliximab (IFM) resistant patient with rheumatoid arthritis (RA). A 44-year-old Japanese woman with RA was treated with prednisolone, cyclosporine A, and methotrexate, which failed to stabilize the disease. Infliximab was then administered and the disease activity was controlled on December 2003. However, RA became active again on June 2004 so that LCAP was administered weekly for 5 weeks. After the LCAP treatment, the ACR20% respon… Show more

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Cited by 2 publications

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Efficacy of High‐Throughput Leukocytapheresis for Rheumatoid Arthritis With a Reduced Response to Infliximab

Sakai

Otsuka

et al. 2009

Ther Apher Dial

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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.

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Efficacy of High‐Throughput Leukocytapheresis for Rheumatoid Arthritis With a Reduced Response to Infliximab

Sakai

Otsuka

et al. 2009

Ther Apher Dial

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Investigation of the clinical usefullness of leukocytapheresis on rheumatoid arthritis resistant to or failed with the other treatments.

Sawada

Kimoto²,

Suzuki³

et al. 2009

Jpn. J. Clin. Immunol.

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summary 〈PURPOSE〉To examine therapeutic eŠect of leukocytapheresis (LCAP) for rheumatoid arthritis (RA) resistant to various treatments.〈METHOD〉Thirteen patients with RA (mean age : 60.8±11.4, male : female＝5 : 8), ◯  who were resistant to disease-modifying anti-rheumatic drugs (DMARDs) and biologics, or ◯  who failed with those medicines because of side eŠects or complications. We performed LCAP, which was carried out once a week for a total of ve sessions, with a throughput of about 0.1 L/kg. Before and after LCAP, we evaluated the eŠect of LCAP therapy. 〈RESULT〉DAS28 (CRP) score was 5.70±1.12 before LCAP, 4.57±1.19 (P＜0.05) just after theˆnal LCAP and 4.83±1.35 (P＜0.05) about 4weeks after LCAP. DAS28 score decreased in all patients after LCAP. No serious adverse events were observed except temporary anemia.〈CONCLUSION〉LCAP therapy may be useful and safe for patients with RA resistant to conventional medication. Patients who show good clinical response by LCAP needs to be clariˆed.

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

Cited by 2 publications

References 9 publications

Efficacy of High‐Throughput Leukocytapheresis for Rheumatoid Arthritis With a Reduced Response to Infliximab

Efficacy of High‐Throughput Leukocytapheresis for Rheumatoid Arthritis With a Reduced Response to Infliximab

Investigation of the clinical usefullness of leukocytapheresis on rheumatoid arthritis resistant to or failed with the other treatments.

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