Immunoadsorption with tryptophan columns: A therapeutic option for the treatment of rheumatoid arthritis with septic complications

Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease affecting multiple organs and tissues. Although there is a wide range of therapeutic applications, the coexistence of severe side effects and contraindications outlines the necessity of new therapeutic options in the treatment of...

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Published in:Journal of clinical apheresis 2009, Vol.24 (1), p.37-41
Main Authors: Thomaidis, Thomas, Schorn, Corinna, Flaig, Wolfram, Lingg, Gerwinn, Schönhals, Elke, Klingel, Reinhard, Galle, Peter R., Schwarting, Andreas
Format: Article
Language:English
Subjects:
Aged
Arthritis, Rheumatoid - complications
Arthritis, Rheumatoid - microbiology
Arthritis, Rheumatoid - therapy
Bacterial Infections
bacterial spondylitis
Humans
immunoadsorption
Immunosorbent Techniques
rheumatoid arthritis
Sepsis - etiology
Sepsis - microbiology
Sepsis - therapy
Spondylitis - microbiology
Steroids - therapeutic use
Treatment Outcome
Tryptophan - therapeutic use
tryptophan columns
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Summary:Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease affecting multiple organs and tissues. Although there is a wide range of therapeutic applications, the coexistence of severe side effects and contraindications outlines the necessity of new therapeutic options in the treatment of severe RA. We report on the case of a 71‐year‐old patient with successful treatment of a complicated RA with tryptophan immunoadsorption combined with low‐dose steroids. Bacterial spondylitis developed in this patient during long‐term treatment with infliximab and methotrexate. Weekly immunoadsorption sessions with tryptophan columns resulted in continuous suppression of RA activity over a period of more than 5 months, as indicated by laboratory findings, the disease activity score, and the visual analog scale. This is the first report of successful treatment of a refractory and complicated RA using tryptophan immunoadsorption columns. In conclusion, immunoadsorption is a safe and effective therapeutic alternative, which should be considered to bridge infectious complications in patients with severe RA. J. Clin. Apheresis, 2009. © 2009 Wiley‐Liss, Inc.
ISSN:0733-2459
1098-1101
DOI:10.1002/jca.20188