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Efficacy of High‐Throughput Leukocytapheresis for Rheumatoid Arthritis With a Reduced Response to Infliximab
Author(s) -
Sakai Yukinao,
Sakai Saori,
Otsuka Tomoyuki,
Ohno Dai,
Murasawa Tsuneo,
Munakata Kazuo,
Mizuno Kyoichi
Publication year - 2009
Publication title -
therapeutic apheresis and dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.415
H-Index - 53
eISSN - 1744-9987
pISSN - 1744-9979
DOI - 10.1111/j.1744-9987.2009.00657.x
Subject(s) - medicine , erythrocyte sedimentation rate , rheumatoid arthritis , rheumatism , infliximab , concomitant , gastroenterology , tumor necrosis factor alpha , c reactive protein , surgery , inflammation
Infliximab (INF), a tumor necrosis factor‐alpha (TNF‐α) 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.