Abstract
To evaluate the efficacy of high-dose leukocytapheresis (LCAP) using a large filter in patients with refractory rheumatoid arthritis (RA), we conducted a multicenter, nonrandomized, open-label clinical study. Thirty patients with highly active RA were treated with high-dose LCAP performed 3–5 sessions at 1-week intervals using a CS-180S filter (CS-180S group); the treatment involves the removal of leukocytes from a higher blood volume per body weight (100^Sml/kg). The clinical response was evaluated at 4 and 8 weeks after a series of LCAP using the 28-joint disease activity score (DAS28). Similar data of 53 patients treated with conventional LCAP (60^Sml/kg) using a standard filter, CS-100, were compared as a control (CS-100 group). The CS-180S filter demonstrated a higher adsorption capacity for leukocytes, particularly lymphocytes. The CS-180S group exhibited significant improvements in each item of DAS28 after treatment although the CS-100 group did not demonstrate such improvements in the CRP level and the ESR. Compared to the CS-100 group, the patients of the CS-180S group exhibited a tendency toward improvement with respect to the CRP level and ESR (P = 0.057 and 0.041, respectively). According to the EULAR improvement criteria based on DAS28, 60% and 45% of the patients from CS-180S and CS-100 groups achieved moderate or more responses, respectively, at 4 weeks after treatment. These results suggest that compared to conventional LCAP, high-dose LCAP may enhance the suppression of RA disease activity.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
InstitutionalAuthorNameThe guideline committee of the Japanese Society for Dialysis Therapy (2002) ArticleTitleGuidelines for the management of rheumatoid arthritis Arthritis Rheum 46 328–46 Occurrence Handle10.1002/art.10148 Occurrence Handle1:CAS:528:DC%2BD38XhvF2ru7o%3D
FC Breedveld P Emery E Keystone K Patel DE Furst JR Kalden et al. (2004) ArticleTitleInfliximab in active early rheumatoid arthritis Ann Rheum Dis 63 149–55 Occurrence Handle14722203 Occurrence Handle10.1136/ard.2003.013961 Occurrence Handle1:CAS:528:DC%2BD2cXhsVGnsLY%3D
PE Lipsky DM van der Heijde EW St Clair DE Furst FC Breedveld JR Kalden et al. (2000) ArticleTitleInfliximab and methotrexate in the treatment of rheumatoid arthritis. Anti-Tumor Necrosis Factor Trial in Rheumatoid Arthritis with Concomitant Therapy Study Group N Engl J Med 343 1594–602 Occurrence Handle11096166 Occurrence Handle10.1056/NEJM200011303432202 Occurrence Handle1:CAS:528:DC%2BD3cXovVeltLk%3D
T Bongartz AJ Sutton MJ Sweeting I Buchan EL Matteson V Montori (2006) ArticleTitleAnti-TNF antibody therapy in rheumatoid arthritis and the risk of serious infections and malignancies: systematic review and meta-analysis of rare harmful effects in randomized controlled trials JAMA 295 2275–85 Occurrence Handle16705109 Occurrence Handle10.1001/jama.295.19.2275 Occurrence Handle1:CAS:528:DC%2BD28Xksl2ktrk%3D
J Tenenbaum MB Urowitz EC Keystone IL Dwosh JE Curtis (1979) ArticleTitleLeucapheresis in severe rheumatoid arthritis Ann Rheum Dis 38 40–4 Occurrence Handle434945 Occurrence Handle1:STN:280:DyaE1M7msVKisA%3D%3D
DJ Wallace D Goldfinger R Gatti C Lowe P Fan R Bluestone JR Klinenberg (1979) ArticleTitlePlasmapheresis and lymphoplasmapheresis in the management of rheumatoid arthritis Arthritis Rheum 22 703–10 Occurrence Handle454499 Occurrence Handle10.1002/art.1780220703 Occurrence Handle1:STN:280:DyaE1M3gvFeiuw%3D%3D
J Karsh DG Wright JH Klippel JL Decker AB Deisseroth MW Flye (1979) ArticleTitleLymphocyte depletion by continuous flow cell centrifugation in rheumatoid arthritis: clinical effects Arthritis Rheum 22 1055–9 Occurrence Handle486218 Occurrence Handle10.1002/art.1780221002 Occurrence Handle1:STN:280:DyaL3c%2FitVeksg%3D%3D
J Karsh JH Klippel PH Plotz JL Decker DG Wright MW Flye (1981) ArticleTitleLymphapheresis in rheumatoid arthritis. A randomized trial Arthritis Rheum 24 867–73 Occurrence Handle7020704 Occurrence Handle10.1002/art.1780240701 Occurrence Handle1:STN:280:DyaL3M3lsFyqtQ%3D%3D
D Wallace D Goldfinger C Lowe S Nichols J Weiner M Brachman et al. (1982) ArticleTitleA double-blind, controlled study of lymphoplasmapheresis versus sham apheresis in rheumatoid arthritis N Engl J Med 306 1406–10 Occurrence Handle7043264 Occurrence Handle1:STN:280:DyaL387psFeqsw%3D%3D Occurrence Handle10.1056/NEJM198206103062307
SM Wahl RL Wilder IM Katona LM Wahl JB Allen I Scher et al. (1983) ArticleTitleLeukapheresis in rheumatoid arthritis. Association of clinical improvement with reversal of anergy Arthritis Rheum 26 1076–84 Occurrence Handle6615562 Occurrence Handle10.1002/art.1780260904 Occurrence Handle1:STN:280:DyaL3szgvVyktg%3D%3D
W Verdickt J Dequeker JL Ceuppens E Stevens K Gautama C Vermylen (1983) ArticleTitleEffect of lymphoplasmapheresis on clinical indices and T cell subsets in rheumatoid arthritis. A double-blind controlled study Arthritis Rheum 26 1419–26 Occurrence Handle6360178 Occurrence Handle10.1002/art.1780261202 Occurrence Handle1:STN:280:DyaL2c%2FotVShtg%3D%3D
T Hidaka K Suzuki Y Matsuki M Takamizawa-Matsumoto K Kataharada T Ishizuka et al. (1999) ArticleTitleFiltration leukocytapheresis therapy in rheumatoid arthritis. A randomized, double-blind, placebo-controlled trial Arthritis Rheum 42 431–7 Occurrence Handle10088764 Occurrence Handle10.1002/1529-0131(199904)42:3<431::AID-ANR6>3.0.CO;2-2 Occurrence Handle1:STN:280:DyaK1M7os1Khtw%3D%3D
Y Ueki S Yamasaki Y Kanamoto T Kawazu M Yano K Matsumoto et al. (2000) ArticleTitleEvaluation of filtration leucocytapheresis for use in the treatment of patient with rheumatoid arthritis Rheumatology 39 165–71 Occurrence Handle10725066 Occurrence Handle10.1093/rheumatology/39.2.165 Occurrence Handle1:STN:280:DC%2BD3c7ptVSnsA%3D%3D
K Kempe H Tsuda K Yang K Yamaji Y Kanai H Hashimoto (2004) ArticleTitleFiltration leukocytapheresis therapy in the treatment of rheumatoid arthritis patients resistant to or failed with methotrexate Ther Apher Dial 8 197–205 Occurrence Handle15154871 Occurrence Handle10.1111/j.1526-0968.2004.00132.x Occurrence Handle1:CAS:528:DC%2BD2cXmtlSlurw%3D
Y Izumi M Tominaga N Iwanaga M Huang F Tanaka K Aratake et al. (2006) ArticleTitleTwenty-four-week follow-up examination of a leukocytapheresis therapy in rheumatoid arthritis Mod Rheumatol 16 20–3 Occurrence Handle16622719 Occurrence Handle10.1007/s10165-005-0448-0
Ueki Y, Sagawa A, Tanimura K, Yamada A, Yamamoto K, Tsuda H, et al. A multicenter study of leukocytapheresis in rheumatoid arthritis. Clin Exp Rheumatol; in press
ML Prevoo MA van ‘t Hof HH Kuper MA van Leeuwen LB van de Putte PL van Riel (1995) ArticleTitleModified disease activity scores that include twenty-eight-joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis Arthritis Rheum 38 44–8 Occurrence Handle7818570 Occurrence Handle10.1002/art.1780380107 Occurrence Handle1:STN:280:DyaK2M7hvVeqtA%3D%3D
DAS-Score.nl [homepage on the Internet]. Netherlands: The department of rheumatology, University Medical Centre Nijmegen. Available from: http://www.das-score.nl/
T Nishimura S Oka N Yamawaki (1994) Technical aspects of leucocyte depletion CF Hogman (Eds) Leucocyte depletion of blood components VU University Press Amsterdam 51–8
Y Ueki H Nakamura Y Kanamoto M Miyazaki M Yano K Matsumoto et al. (2001) ArticleTitleComparison of lymphocyte depletion and clinical effectiveness on filtration leukocytapheresis in patients with rheumatoid arthritis Ther Apher 5 455–61 Occurrence Handle11800080 Occurrence Handle10.1046/j.1526-0968.2001.00375.x Occurrence Handle1:STN:280:DC%2BD38%2FnsVarsw%3D%3D
T Hidaka K Suzuki Y Matsuki M Takamizawa-Matsumoto M Okada T Ishizuka et al. (1999) ArticleTitleChanges in CD4+ T lymphocyte subsets in circulating blood and synovial fluid following filtration leukocytapheresis therapy in patients with rheumatoid arthritis Ther Apher 3 178–85 Occurrence Handle10341394 Occurrence Handle10.1046/j.1526-0968.1999.00136.x Occurrence Handle1:STN:280:DyaK1M3nt12nsg%3D%3D
RW Kinne R Brauer B Stuhlmuller E Palombo-Kinne GR Burmester (2000) ArticleTitleMacrophages in rheumatoid arthritis Arthritis Res 2 189–202 Occurrence Handle11094428 Occurrence Handle10.1186/ar86 Occurrence Handle1:CAS:528:DC%2BD3cXlslyis7g%3D
G Hahn B Stuhlmuller N Hain JR Kalden K Pfizenmaier GR Burmester (1993) ArticleTitleModulation of monocyte activation in patients with rheumatoid arthritis by leukapheresis therapy J Clin Invest 91 862–70 Occurrence Handle8450066 Occurrence Handle1:CAS:528:DyaK3sXisVSqsr8%3D Occurrence Handle10.1172/JCI116307
F Wang NS Wang CG Yan JH Li LQ Tang (2007) ArticleTitleThe significance of platelet activation in rheumatoid arthritis Clin Rheumatol 26 768–71 Occurrence Handle17279322 Occurrence Handle10.1007/s10067-007-0550-0
K Fukunaga Y Fukuda Y Yokoyama K Ohnishi T Kusaka T Kosaka et al. (2006) ArticleTitleActivated platelets as a possible early marker to predict clinical efficacy of leukocytapheresis in severe ulcerative colitis patients J Gastroenterol 41 524–32 Occurrence Handle16868799 Occurrence Handle10.1007/s00535-006-1789-y
Y Yagi A Andoh O Inatomi S Bamba T Tsujikawa Y Fujiyama et al. (2006) ArticleTitleModulation of platelet aggregation responses by leukocytapheresis therapy in patients with active ulcerative colitis J Gastroenterol 41 540–6 Occurrence Handle16868801 Occurrence Handle10.1007/s00535-006-1797-y
S Onuma K Yamaji K Kempe M Ogasawara T Ogawa K Yang et al. (2006) ArticleTitleInvestigation of the clinical effect of large volume leukocytapheresis on methotrexate-resistant rheumatoid arthritis Ther Apher Dial 10 404–11 Occurrence Handle17096694 Occurrence Handle10.1111/j.1744-9987.2006.00403.x
Author information
Authors and Affiliations
Consortia
Corresponding author
About this article
Cite this article
Eguchi, K., Saito, K., Kondo, M. et al. Enhanced effect of high-dose leukocytapheresis using a large filter in rheumatoid arthritis. Mod Rheumatol 17, 481–485 (2007). https://doi.org/10.1007/s10165-007-0630-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10165-007-0630-7