関節リウマチに対する大量血球処理白血球除去療法(<特集>アフェレシス療法における新しいmodality)

概要

論文の詳細を見る
Although the recent development of disease-modifying anti-rheumatic drugs (DMARDs), including biological agents, has created a wide range of therapeutic options for rheumatoid arthritis (RA), there are many patients who insufficiently respond to multiple DMARDs or who cannot receive DMARDs because of complications and infections. Leukocytapheresis (LCAP) is reported to suppress disease activity in patients with active RA refractory to multiple DMARDs. We conducted a multi-center, open-label clinical study in order to evaluate the efficacy of high-dose LCAP using a large filter (CS-180S) in refractory RA. High-dose LCAP was performed for 3-5 sessions at 1-week intervals using a CS-180S; the treatment involves the removal of leukocytes from a higher blood volume per body weight (100ml/kg). Similar data with conventional LCAP (60ml/kg) using a standard filter, CS-100, were compared as a control (CS-100 group). The CS-180S group exhibited significant improvements in each item of 28-joint disease activity score (DAS 28) after treatment although the CS-100 group did not demonstrate such improvements in the CRP level and the ESR. According to the EULAR improvement criteria, 60% and 45% of the patients from the CS-180S and CS-100 groups achieved moderate or better responses, respectively, at 4 weeks after treatment. High-dose LCAP may enhance the suppression of RA disease activity.
日本アフェレシス学会の論文
2009-10-31