Document Detail


Efficacy of high-throughput leukocytapheresis for rheumatoid arthritis with a reduced response to infliximab.
MedLine Citation:
PMID:  19527463     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Yukinao Sakai; Saori Sakai; Tomoyuki Otsuka; Dai Ohno; Tsuneo Murasawa; Kazuo Munakata; Kyoichi Mizuno
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy     Volume:  13     ISSN:  1744-9987     ISO Abbreviation:  Ther Apher Dial     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-06-16     Completed Date:  2009-08-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101181252     Medline TA:  Ther Apher Dial     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  179-85     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Nippon Medical School Musashikosugi Hospital, Kanagawa, Japan. y-sakai@nms.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Adult
Antibodies, Monoclonal / therapeutic use*
Antirheumatic Agents / therapeutic use*
Arthritis, Rheumatoid / therapy*
Blood Sedimentation
C-Reactive Protein / metabolism
Female
Humans
Leukapheresis / methods*
Male
Middle Aged
Severity of Illness Index
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Antirheumatic Agents; 0/infliximab; 9007-41-4/C-Reactive Protein

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