Abstract
The authors studied a total of 392 cryofiltration (CF) treatments on twenty-four patients with rheumatoid arthritis (RA) and efficacy of CF therapy was clinically evaluated.
A rapid improvement in the arthralgia, morning stiffness and general malaise in all patients was obtained by CF therapy. After CF therapy, some patients could stop steroid therapy or decrease the maintenance dose of steroid and anti-inflammatory drugs. The therapeutic response to CF therapy was divided into two groups. One group showed a marked rebound phenomenon of clinical symptoms after each CF therapy initially, then the degree of rebound phenomenon gradually decreased. The other group did not show this marked rebound phenomenon. Serum levels of α1-globulin, RAHA, IgA, IgM and C3 were significantly different between the rebound phenomenon-negative and -positive groups. However, differences in α1-globulin and C3 were small, and variance in RAHA was large, and these parameters were not good indicators for distinguishing clinical response to CF therapy. There was a significant negative correlation between time of plugging the second filter and serum IgM concentration. This means that if serum IgM concentration becomes high, cryogel in the second filter increases. Therefore, we consider that serum IgM is a good indicator to distinguish these two groups. We measured Lansbery scores before and after each CF therapy to evaluate objective improvement of clinical manifestations. And we compared Lansbery scores before and after each CF therapy to examine a short-term therapeutic efficacy. Moreover, we examined Lansbery scores at entering and leaving the hospital and reduction rate between two columns for a long-term therapeutic efficacy. Lansbery scores before and after each CF therapy decreased significantly after CF therapy. We evaluated a long-term therapeutic efficacy of CF therapy as follows; excellent, if reduction rate was over 50%, good, 30-40%, moderate, 15-29%, and poor, 15%. Six patients showed excellent, ten showed good, six showed moderate, and two showed poor response.
We conclude that CF therapy has clinical benefits in chronic rheumatoid arthritis.
