CASE REPORT

Improved response to infliximab after leukocytapheresis in a patent with rheumatoid arthritis

Authors

Teruhisa Azuma^1,2, Hiroyasu Ishimaru¹, Kazuhiro Hatta¹ and Yoshiaki Kori¹

1. Department of General Internal Medicine, Tenri Hospital, 200 Mishima-cho, Tenri 632-0015, Japan
2. Present address: Hematology Divisoin, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan

Received:

05 June 2006

Accepted:

05 February 2007

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Abstract

This is the first report on effective leukocytapheresis (LCAP) in an acquired infliximab (IFM) resistant patient with rheumatoid arthritis (RA). A 44-year-old Japanese woman with RA was treated with prednisolone, cyclosporine A, and methotrexate, which failed to stabilize the disease. Infliximab was then administered and the disease activity was controlled on December 2003. However, RA became active again on June 2004 so that LCAP was administered weekly for 5 weeks. After the LCAP treatment, the ACR20% response was obtained again and IFM has regained its efficacy.

Key words

Acquired resistance - Infliximab (IFM) - Leukocytapheresis (LCAP) - Rheumatoid arthritis