Plasmapheresis and lymphoplasmapheresis in the management of rheumatoid arthritis.
We have demonstrated the efficacy of therapeutic pheresis in a number of rheumatic diseases, especially rheumatoid arthritis (RA). Ten of 12 patients with RA went into remissions averaging 4 months. These patients were pheresed 20 times over 11 weeks in a tapering fashion on a Haemonetics Model 30 Blood Processor. Clinical remissions were sustained even though serologies, immunoglobulins, immune functions, sedimentation rates, and circulating immune complexes returned to their pre-pheresis baseline by pheresis number 20. All these patients were taking gold or D-penicillamine concurrently, but neither of the 2 patients who failed to respond was on these agents. Plasmapheresis was just as effective as lymphoplasmapheresis. It is theorized that removal of a plasma factor that modulates lymphocyte or neutrophil function produces remissions in RA and that long-acting drugs (e.g., gold or penicillamine) are able to prevent its continued production and produce a sustained remission.
D000328:Adult; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000276:immunology / Q000628:therapy*; D005069:Evaluation Studies as Topic; D005260:Female; D006046:Gold / Q000627:therapeutic use; D006801:Humans; D007136:Immunoglobulins / Q000032:analysis; D007213:Indomethacin / Q000627:therapeutic use; D007937:Leukapheresis; D008124:Locomotion; D008212:Lymphocyte Depletion / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010396:Penicillamine / Q000627:therapeutic use; D010956:Plasmapheresis; D011241:Prednisone / Q000627:therapeutic use
D007136:Immunoglobulins; D006046:Gold; D010396:Penicillamine; D011241:Prednisone; D007213:Indomethacin