Uncontrolled trial of cryofiltration in rheumatoid arthritis

Abstract

In an open trial of cryofiltration in rheumatoid arthritis at our institution, 19 patients received 464 treatments; the intensive schedule of ten treatments in 5 weeks was completed in 14 of the 19, and excellent to good clinical response was achieved in ten of these. The combined results demonstrated significant reductions in Ritchie index, morning stiffness, and 50-foot-walk time in the intensive treatment period, as well as significant increases in hand grip strengths. In the maintenance treatment period treatment frequency was individually selected and at less frequent intervals. Changes in clinical parameters were notably less. Although significant correlations were observed between the percent change in clinical parameters and the percent change in biochemical and hematological parameters, no consistent pattern was found. The favorable results of this trial and other uncontrolled trials has led to a two-center double-blind controlled trial of cryofiltration in rheumatoid arthritis that is now in progress.

The selective therapeutic apheresis procedures

“…The cryofilter is an example of secondary plasma processing that has been used over the last three decades to treat a variety of clinical diseases including but not limited to rheumatoid arthritis , cryoglobulinemia , cold hemagglutinin disease and ulcerative colitis . It has also been used in kidney transplantation to treat HLA antibody and ABO incompatibility .…”

Therapeutic Apheresis in Hematologic, Autoimmune and Dermatologic Diseases With Immunologic Origin

“…Because both cellular and humoral mechanisms are involved in the pathogenesis of rheumatoid arthritis, in recent years TPE, cryofiltration, lymphoplasmapheresis, and leukocytapheresis have been implemented in addition to immunosuppressive therapy in particularly severe cases . The clinical results of cryofiltration, double filtration, IA, and leukocytapheresis are very encouraging; these methods could be a regular therapy for rheumatoid arthritis, particularly in those patients with poorly controlled disease on immune suppressive or anti‐TNF therapy .…”

Birth of the Concept and the Development of Extracorporeal Immunomodulation

“…The process is accepted widely and is very popular in Japan, and there have been many reports on the clinical effectiveness in the treatment of collagen diseases, hematological diseases, neurological diseases, and transplantations. Cryofiltration is regarded as a modified technique of DFPP in which plasma fractionation is conducted at a cold temperature in an attempt to remove cryogel containing the pathogenic substances (7).…”