Immunoadsorption and plasmapheresis are equally efficacious as adjunctive therapies for severe lupus nephritis.

Autor: Loo CY; Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia. Electronic address: cyloo@gmail.com., Mohamed Said MS; Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia. Electronic address: drobiwan@gmail.com., Mohd R; Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia. Electronic address: rozita@gmail.com., Abdul Gafor AH; Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia. Electronic address: halimgafor@gmail.com., Saidin R; Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia. Electronic address: drbulat@gmail.com., Halim NA; Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia. Electronic address: norma@gmail.com., Chua MK; Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia. Electronic address: kwichua@gmail.com., Kong NCT; Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia. Electronic address: norellakong@gmail.com.
Jazyk: angličtina
Zdroj: Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis [Transfus Apher Sci] 2010 Dec; Vol. 43 (3), pp. 335-340. Date of Electronic Publication: 2010 Nov 03.
DOI: 10.1016/j.transci.2010.10.003
Abstrakt: This was a prospective randomized controlled trial to evaluate the effects of immunoadsorption (IA) versus conventional PP (PP) as adjunctive therapy in the treatment of severe lupus nephritis (LN). Of 28 patients with biopsy-proven severe LN (ISN/RPS classes III or IV ± V), 14 underwent 36 sessions of PP and the other 41 sessions of IA in addition to our center's standard LN treatment protocol. Three patients in the PP group and 2 in the IA group experienced a transient, marked drop in platelets with the second session. Except for a higher pre treatment mean SLEDAI score in the PP group 17.4 ± 2.0 vs. 13.5 ± 4.8; p = 0.009 and a serum creatinine of 163 ± 7.9 vs. 81.7 ± 10.2; p = 0.33, there were no other baseline differences. Some differences did exist between the two therapies in the immediate post-treatment phase, at 1 and 3 months. Three in IA relapsed, none of PP in third months, whereas two patients relapsed in the PP and none of IA cohorts at 6 months. However, most of these parameters did not differ by 6 months. The pre- and post-therapy SLEDAI scores remained different 12.4 ± 4.5 vs. 9 ± 4; p = 0.04 at 1 month, and at 3 month 13.5 ± 4.7 vs. 7.7 ± 1.1; p = 0.012 but not at 6 months. We conclude that IA and PP were equally well tolerated and efficacious as adjunctive therapy for severe LN.
(Copyright © 2010 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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