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Plasmapheresis and subsequent pulse cyclophosphamide versus pulse cyclophosphamide alone in severe lupus: Design of the LPSG trial
Author(s) -
Clark William F.,
Dau Peter C.,
Euler Hans H.,
Guillevin Loïc,
Hasford Joerg,
Heer Andreas H.,
Jones J. Verrier,
Kashgarian Michael,
Knatterud Genell,
Lockwood C. Martin,
Pusey Charles D.,
Rifle Gérard,
Robinson John A.,
Schroeder Johann O.,
Tan Eng M.,
Wallace Daniel J.,
Weiner Steven R.
Publication year - 1991
Publication title -
journal of clinical apheresis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.697
H-Index - 46
eISSN - 1098-1101
pISSN - 0733-2459
DOI - 10.1002/jca.2920060109
Subject(s) - medicine , plasmapheresis , cyclophosphamide , pulse (music) , systemic lupus erythematosus , dermatology , immunology , surgery , chemotherapy , antibody , disease , detector , electrical engineering , engineering
A group of clinics are collaborating in the Lupus Plasmapheresis Study Group (LPSG) to investigate whether repeated plasmapheresis prior to pulse cyclophosphamide improves the therapeutical results in severe systemic lupus erythematosus (SLE). The underlying rationale is the hypothesis that plasmapheresis 1) eliminates pathogenic autoantibodies and immune complexes and 2) induces compensatory lymphocyte activation via feedback mechanisms between circulating antibodies and their respective clones (“antibody rebound”). It should be possible to utilize this enhanced activity for increased clonal deletion if pulse cyclophosphamide is applied shortly after plasmapheresis. Accordingly, in a randomized study, the LPSG will be comparing the repeated application of pulse cyclophosphamide alone with a treatment involving repeated plasmapheresis prior to the cyclophosphamide pulses in severe SLE. A third arm of the study will be gathering experience with a more intensified procedure. This overview summarizes the most important details of the planned study.