Abstract: 【Abstract】Objective To investigate the efficacy and safety of immunoadsorption combined with recombinant human tumor necrosis factor receptor fusion protein for the treatment of active rheumatoid arthritis. Methods We analyzed 65 active rheumatoid arthritis patients in this study. In combined group, 38 patients
were treated with immunoadsorption combined with recombinant human tumor necrosis factor receptor fusion protein and disease- modifying anti- rheumatic drugs (DMARDs, LEF or MTX); In biological agent group, 27 patients were treated with recombinant human tumor necrosis factor receptor fusion protein and
DMARDs (LEF or MTX). Clinical symptoms and laboratory examination changes were collected before and after treatment for 4 weeks and 24 weeks. Clinical assessments used the American College of Rheumatology criteria (ACR). Adverse events were evaluated during the treatment. Results All patients completed the treatment. At the treatment for 4 weeks, the improvement of tender joint counts, swollen joint counts, time of morning stiffness, ESR and CRP were greater in combined group than in biological agent group (Z=2.733, 2.604, 2.366, 4.137, 2.952, respectively, P＜0.05), and the improvement of DAS28 and HAQ scores were also greater in combined group than in biological agent group (Z=4.134 and 3.262, respectively, P＜0.05). At thetreatment for 24 weeks, the rates of ACR20, ACR50, and ACR70 were 94.7%, 92.1% and 81.5%, respectively, in combined group, and were 74.1%, 59.3% and 44.4%, respectively, in biological agent group (χ2=4.050, 10.077 and 9.721, respectively; P＜0.05). Conclusion Immunoadsorption in combination with recombinant human tumor necrosis factor receptor fusion protein significantly altered the signs and symptoms of rheumatoid arthritis, suggesting that this therapy may be an alternative for the remission induction of rheumatoid arthritis.

Key words: Rheumatoid arthritis, Immunoadsorption, Recombinant human tumor necrosis factor receptor fusion protein, Remission induction