Efficacy of combined therapy with plasmapheresis and immunosuppressants in rheumatoid vasculitis.

The combined effects of plasmapheresis and immunosuppressive therapy in the treatment of rheumatoid vasculitis was evaluated in 8 patients. These modalities, in combination, proved to promote rapid healing of cutaneous ulcers. In addition, it appeared that this aggressive therapy can occasionally reverse early gangrenous lesions involving extremities. By contrast, little change occurred in longstanding neuropathic manifestations. Our preliminary results suggest that plasmapheresis, used as an acute treatment modality, and combined with prolonged therapy with immunosuppressive drugs, may reduce the morbidity associated with certain manifestations of rheumatoid vasculitis.