SLE study supports immunoadsorption

A recent pilot study reports that biochemical and disease activity indices are improved by immunoglobulin immunoadsorption (IAS) in systemic lupus erythematosus (SLE) patients.Lead author Dr Stummvoll introduces the current study by commenting, "SLE treatment, in general, and immunosuppression, in particular, ultimately aims at interfering with autoantibody formation... whilst IAS allows for the specific and nearly complete clearance of circulating IgG and immune complexes (ICs), while neither removing other plasma proteins nor necessitating substitution with fresh frozen plasma or albumin."In the current long-term observational study, 16 patients received IAS for three months. Participants had severe SLE and renal disease, and cyclophosphamide treatment was contraindicated or failed to halt disease progression.Patients achieving at least 20% improvement in two or more of the outcome measures were considered responders and offered a nine-month extension period.Within three months of therapy, 14 patients responded and 11 opted for an extension. Mean proteinuria decreased from 6.7g/day to 4.3g/day at three months and 2.9g/day at 12 months (pSteroids could be tapered from a mean of 117mg/day at baseline to 29mg/day at three months and 9mg/day at 12 months. Disease activity improved for a range of scoring scales (SIS, SLEDAI, p"In this negatively selected cohort of patients with SLE, IAS was associated with a significant response shown by reduced proteinuria, improved global disease activity, decreased anti-dsDNA, and lower glucocorticoid dosages, suggesting therapeutic benefit," Dr Stummvoll's group write.The investigators add, "Patients receiving IAS did not appear to be more prone to adverse events and infections than expected given their rather high disease activity. Prospective controlled trials are warranted to determine conclusively the role of IAS in SLE treatment."Reference...