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Chinese Journal of Blood Purification ›› 2007, Vol. 6 ›› Issue (6) : 308-311.

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Abstract

Objective To investigate the efficacy of immunoclearance in combination with immunosuppressive in treatment of refractory rheumatoid arthritis. Methods We retrospectively analyzed 60 refractory rheumatoid arthritis patients. All of them had received regular disease-modifying antirheumatic drugs (DMARDs) and/or immunosuppressives for more than one year and the symptoms were not relieved. In combination therapy group, 34 patients received 1 to 3 times of immunoclearance before leflunomide treatment (10~20mg/d). Twenty six patients receiving leflunomide treatment only were observed as a control group. Clinical symptoms and laboratory examinations including blood routine, liver functions, immunoglobulins, rheumatoid factor (RF), hidden rheumatoid factor (HRF), antibody to cyclic citrullinated peptide (CCP) and anti-keratin antibody (AKA) were observed before and after treatment for one year. Results In combination therapy group after treatment for one year, arthritis symptoms improved significantly, as did erythrocyte sediment rate (ESR), immunoglobulins, RF, HRF and AKA, when comparison was made with those before and after the treatment for 3 months. Patients in combination group had no side effects of hemodynamic disturbances. Conclusions In treatment of refractory RA, immunoclearance in combination with immunosuppressive has the advantage of faster efficacy and less side effects and is superior to DMARDs or immunosuppressive therapy