Plasmapheresis therapy in combination with TNF-α inhibitor and DMARDs: A multitarget method for the treatment of rheumatoid arthritis.
OBJECTIVE
To evaluate the effects of a multitarget method involving plasmapheresis therapy combined with tumor necrosis factor (TNF)-α inhibitor and disease-modifying antirheumatic drugs (DMARDs) on disease activity parameters in the treatment of active rheumatoid arthritis (RA).


METHODS
Sixty-five patients with active RA were divided into two groups according to the treatment administered: the plasmapheresis combination therapy group (Plasmapheresis combination group; 38 cases), in which patients received plasmapheresis therapy along with a TNF-α inhibitor (recombinant human tumor necrosis factor-Fc; rhTNFR:Fc; Etanercept biosimilars) and DMARDs, and a TNF-α inhibitor therapy group (biological agent group; 27 cases), in which patients received a TNF-α inhibitor and DMARDs. Clinical parameters were measured before and at 4 and 24 weeks after treatment.


RESULTS
ACR20, ACR50, and ACR70 responses at week 4 were achieved in 84.2%, 78.9%, and 60.5% of the patients in the plasmapheresis combination group, respectively, and 74.1%, 55.6%, and 29.6% of the patients in the biological agent group, respectively. The ACR50 and ACR70 response rates were superior in the former than the latter group (p < 0.05). Similar patterns of statistical significance were observed for ACR20, ACR50, and ACR70 responses at week 24 after the treatment. ACR50 responses were achieved in 84.2% patients and ACR70 responses were achieved in 76.3% patients in the plasmapheresis combination group, and these proportions were better than those in the biological agent group (p < 0.05).


CONCLUSIONS
The multitarget method combining plasmapheresis, TNF-α inhibitor, and DMARDs for RA therapy was superior to the combination of TNF-α inhibitor for reducing disease activity parameters in patients with active RA.
a Department of Rheumatology and Immunology , National Center of Gerontology, Beijing Hospital , Beijing , China and.
Yongjing
Y
Cheng
a Department of Rheumatology and Immunology , National Center of Gerontology, Beijing Hospital , Beijing , China and.|b Department of Respiratory and Critical Care Medicine , China Rehabilitation Research Center, Beijing Bo'ai Hospital , Beijing , China.
Feng
F
Yang
a Department of Rheumatology and Immunology , National Center of Gerontology, Beijing Hospital , Beijing , China and.
Cibo
C
Huang
a Department of Rheumatology and Immunology , National Center of Gerontology, Beijing Hospital , Beijing , China and.
Jia
J
Huang
a Department of Rheumatology and Immunology , National Center of Gerontology, Beijing Hospital , Beijing , China and.
Qian
Q
Wang
a Department of Rheumatology and Immunology , National Center of Gerontology, Beijing Hospital , Beijing , China and.
Yingjuan
Y
Chen
a Department of Rheumatology and Immunology , National Center of Gerontology, Beijing Hospital , Beijing , China and.
Yingjue
Y
Du
a Department of Rheumatology and Immunology , National Center of Gerontology, Beijing Hospital , Beijing , China and.
Like
L
Zhao
a Department of Rheumatology and Immunology , National Center of Gerontology, Beijing Hospital , Beijing , China and.
Ming
M
Gao
a Department of Rheumatology and Immunology , National Center of Gerontology, Beijing Hospital , Beijing , China and.
Fang
F
Wang
D000328:Adult; D018501:Antirheumatic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000628:therapy; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D000068800:Etanercept / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010956:Plasmapheresis / Q000379:methods*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha; D000068800:Etanercept
Disease-modifying antirheumatic drugs; Plasmapheresis; Rheumatoid arthritis; Tumor necrosis factor-α inhibitor