[Immunoadsorption in rheumatic autoimmune diseases: an alternative treatment option : Retrospective insights on the clinical application from the Rhineland-Palatinate Rheumatology Center].

BACKGROUND

Systemic inflammatory rheumatic diseases are frequently linked to significant morbidity and, in some cases, can lead to severe, chronic disease courses. Early and effective treatment strategies are required to prevent irreversible damage. Drug-based immunosuppression is not possible for all patients. In such cases the use of alternative treatment, such as immunoadsorption (IA) is of particular interest. Despite positive clinical experiences, the data on the use of IA in rheumatic diseases are limited.

OBJECTIVE

The aim was to analyze the application, efficacy and safety of IA under routine conditions.

MATERIAL AND METHODS

In this retrospective study immunoadsorption (IA) treatment was performed 373 times in 31 patients with various rheumatic diseases.

RESULTS AND DISCUSSION

The results show that IA was predominantly used in combination with other medicinal procedures, often as a bridging therapy or as a last resort in complex cases. The treatment showed a good safety profile: 25% of patients experienced mainly mild side effects such as a short-term drops in blood pressure. The use of IA led to a significant reduction in immunoglobulin levels. A positive clinical therapeutic effect was observed in 48% of the cases. Shorter intervals between treatments were associated with a better clinical response (p = 0.004). A correlation between a positive therapeutic effect and the concomitant glucocorticoid therapy could not be established (p = 0.611), which could potentially indicate an independent effect of IA.

CONCLUSION

The use of IA can be a valuable addition to individualized treatment approaches and should be further evaluated in future studies.