PLASMAPHERESIS AND SUBSEQUENT PULSE CYCLOPHOSPHAMIDE IN SEVERE SYSTEMIC LUPUS-ERYTHEMATOSUS - AN INTERIM-REPORT OF THE LUPUS-PLASMAPHERESIS-STUDY-GROUP

Citation
Hh. Euler et L. Guillevin, PLASMAPHERESIS AND SUBSEQUENT PULSE CYCLOPHOSPHAMIDE IN SEVERE SYSTEMIC LUPUS-ERYTHEMATOSUS - AN INTERIM-REPORT OF THE LUPUS-PLASMAPHERESIS-STUDY-GROUP, Annales de medecine interne, 145(5), 1994, pp. 296-302
Citations number
43
Categorie Soggetti
Medicine, General & Internal
Journal title
ISSN journal
0003410X
Volume
145
Issue
5
Year of publication
1994
Pages
296 - 302
Database
ISI
SICI code
0003-410X(1994)145:5<296:PASPCI>2.0.ZU;2-3
Abstract
The rarity with which therapy-free remission is achieved in patients w ith severe SLE demand the continued search for improved treatment stra tegies. Possibly, therapeutic results can be improved by means of a '' synchronized'' combination of plasmaphereses followed by pulse cycloph osphamide (Ctx). If the hypothesis is correct, that plasmapheresis ind uces a compensatory ''rebound'' proliferation of pathogenic clones, th en pulse Ctx applied immediately after plasmapheresis should attack th ese activated clones when they are most vulnerable and, ideally, elimi nate them. Employing a strict variant of this strategy in a pilot stud y, treatment-free remission lasting now for up to 7 years were achieva ble in 8 of 14 SLE patients. The Lupus Plasmapheresis Study Group (LPS G) is currently conducting a randomized international multicenter tria l comparing a synchronized procedure with the administration of pulse Ctx alone. The present paper explains the rationale of synchronization and reports on the interim status of the LPSG Study.