Plasma exchange alone versus combination with intravenous immunoglobulin/methylprednisolone pulse therapy in severe systemic rheumatic diseases: a retrospective study
BackgroundFor severe systemic rheumatic diseases (SRDs), therapeutic plasma exchange (TPE) may be applied as a rescue therapy; it usually combined with intravenous immunoglobulin (IVIG) or intravenous methylprednisolone pulse (IVMP) in severe SRDs. However, the necessity of this combination treatmen...
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Frontiers Media S.A.
2024-12-01
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| author | Jing Guo Jing Guo Jing Guo Shuiwen Li Shuiwen Li Shuiwen Li Hao Xu Hao Xu Hao Xu Xinxin Wang Xinxin Wang Xinxin Wang Weiyuan Luo Weiyuan Luo Weiyuan Luo Jie Sun Jie Sun Jie Sun Jianhua Li Jianhua Li Jianhua Li Zhu Chen Zhu Chen Zhu Chen Guiyang Lu Guiyang Lu Guiyang Lu Xiaolong Huang Xiaolong Huang Xiaolong Huang Shiju Chen Shiju Chen Yaogui Ning Yaogui Ning Yaogui Ning |
| author_facet | Jing Guo Jing Guo Jing Guo Shuiwen Li Shuiwen Li Shuiwen Li Hao Xu Hao Xu Hao Xu Xinxin Wang Xinxin Wang Xinxin Wang Weiyuan Luo Weiyuan Luo Weiyuan Luo Jie Sun Jie Sun Jie Sun Jianhua Li Jianhua Li Jianhua Li Zhu Chen Zhu Chen Zhu Chen Guiyang Lu Guiyang Lu Guiyang Lu Xiaolong Huang Xiaolong Huang Xiaolong Huang Shiju Chen Shiju Chen Yaogui Ning Yaogui Ning Yaogui Ning |
| author_sort | Jing Guo |
| collection | DOAJ |
| description | BackgroundFor severe systemic rheumatic diseases (SRDs), therapeutic plasma exchange (TPE) may be applied as a rescue therapy; it usually combined with intravenous immunoglobulin (IVIG) or intravenous methylprednisolone pulse (IVMP) in severe SRDs. However, the necessity of this combination treatment strategy in SRDs remains uncertain.ObjectiveThis retrospective study aimed to evaluate the effectiveness of TPE alone versus TPE combined with IVIG/IVMP in treating severe SRDs.MethodsPatients with severe SRDs treated with TPE who were admitted to the department of intensive care unit (ICU) from January 2011 to December 2019 were included. These patients were divided into two groups: the TPE-alone group (TPE group) and the TPE plus IVIG/IVMP group (TPE + IVIG/IVMP group). The patients’ clinical characteristics, the Sequential Organ Failure Assessment score, the 28-day mortality rate, and the length of ICU stay were evaluated in the two groups.ResultsNinety-one patients were enrolled in this study: 51 patients in the TPE group and 40 patients in the TPE + IVIG/IVMP group. In the TPE group, the median age was 51.39 ± 15.34 years, and 64.71% were women. In the TPE + IVIG/IVMP group, the median age of the patients was 42.93 ± 16.56 years, and 75% were women. The infection rate in the TPE + IVIG/IVMP group was significantly higher than that in the TPE group (P < 0.05). Both the 28-day mortality and the length of ICU stay did not differ statistically between the two groups (P > 0.05).ConclusionThis study showed no benefit of combing IVIG/IVMP with TPE in improving the outcome of patients with severe SRDs, suggesting that IVIG/IVMP may not be necessary when used conjunction with TPE for the treatment of severe SRDs. |
| format | Article |
| id | doaj-art-e2e1493db64a42ff926dffb2ce41b0db |
| institution | Kabale University |
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| language | English |
| publishDate | 2024-12-01 |
| publisher | Frontiers Media S.A. |
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| spelling | doaj-art-e2e1493db64a42ff926dffb2ce41b0db2025-01-16T09:34:26ZengFrontiers Media S.A.Frontiers in Immunology1664-32242024-12-011510.3389/fimmu.2024.14546911454691Plasma exchange alone versus combination with intravenous immunoglobulin/methylprednisolone pulse therapy in severe systemic rheumatic diseases: a retrospective studyJing Guo0Jing Guo1Jing Guo2Shuiwen Li3Shuiwen Li4Shuiwen Li5Hao Xu6Hao Xu7Hao Xu8Xinxin Wang9Xinxin Wang10Xinxin Wang11Weiyuan Luo12Weiyuan Luo13Weiyuan Luo14Jie Sun15Jie Sun16Jie Sun17Jianhua Li18Jianhua Li19Jianhua Li20Zhu Chen21Zhu Chen22Zhu Chen23Guiyang Lu24Guiyang Lu25Guiyang Lu26Xiaolong Huang27Xiaolong Huang28Xiaolong Huang29Shiju Chen30Shiju Chen31Yaogui Ning32Yaogui Ning33Yaogui Ning34Department of Intensive Care Unit, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, ChinaSchool of Medicine, Xiamen University, Xiamen, Fujian, ChinaThe School of Clinical Medicine, Fujian Medical University, Fuzhou, Fujian, ChinaDepartment of Intensive Care Unit, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, ChinaSchool of Medicine, Xiamen University, Xiamen, Fujian, ChinaThe School of Clinical Medicine, Fujian Medical University, Fuzhou, Fujian, ChinaDepartment of Intensive Care Unit, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, ChinaSchool of Medicine, Xiamen University, Xiamen, Fujian, ChinaThe School of Clinical Medicine, Fujian Medical University, Fuzhou, Fujian, ChinaDepartment of Intensive Care Unit, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, ChinaSchool of Medicine, Xiamen University, Xiamen, Fujian, ChinaThe School of Clinical Medicine, Fujian Medical University, Fuzhou, Fujian, ChinaDepartment of Intensive Care Unit, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, ChinaSchool of Medicine, Xiamen University, Xiamen, Fujian, ChinaThe School of Clinical Medicine, Fujian Medical University, Fuzhou, Fujian, ChinaDepartment of Intensive Care Unit, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, ChinaSchool of Medicine, Xiamen University, Xiamen, Fujian, ChinaThe School of Clinical Medicine, Fujian Medical University, Fuzhou, Fujian, ChinaDepartment of Intensive Care Unit, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, ChinaSchool of Medicine, Xiamen University, Xiamen, Fujian, ChinaThe School of Clinical Medicine, Fujian Medical University, Fuzhou, Fujian, ChinaDepartment of Intensive Care Unit, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, ChinaSchool of Medicine, Xiamen University, Xiamen, Fujian, ChinaThe School of Clinical Medicine, Fujian Medical University, Fuzhou, Fujian, ChinaDepartment of Intensive Care Unit, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, ChinaSchool of Medicine, Xiamen University, Xiamen, Fujian, ChinaThe School of Clinical Medicine, Fujian Medical University, Fuzhou, Fujian, ChinaDepartment of Intensive Care Unit, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, ChinaSchool of Medicine, Xiamen University, Xiamen, Fujian, ChinaThe School of Clinical Medicine, Fujian Medical University, Fuzhou, Fujian, ChinaSchool of Medicine, Xiamen University, Xiamen, Fujian, ChinaDepartment of Rheumatology and Clinical Immunology, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, ChinaDepartment of Intensive Care Unit, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, ChinaSchool of Medicine, Xiamen University, Xiamen, Fujian, ChinaThe School of Clinical Medicine, Fujian Medical University, Fuzhou, Fujian, ChinaBackgroundFor severe systemic rheumatic diseases (SRDs), therapeutic plasma exchange (TPE) may be applied as a rescue therapy; it usually combined with intravenous immunoglobulin (IVIG) or intravenous methylprednisolone pulse (IVMP) in severe SRDs. However, the necessity of this combination treatment strategy in SRDs remains uncertain.ObjectiveThis retrospective study aimed to evaluate the effectiveness of TPE alone versus TPE combined with IVIG/IVMP in treating severe SRDs.MethodsPatients with severe SRDs treated with TPE who were admitted to the department of intensive care unit (ICU) from January 2011 to December 2019 were included. These patients were divided into two groups: the TPE-alone group (TPE group) and the TPE plus IVIG/IVMP group (TPE + IVIG/IVMP group). The patients’ clinical characteristics, the Sequential Organ Failure Assessment score, the 28-day mortality rate, and the length of ICU stay were evaluated in the two groups.ResultsNinety-one patients were enrolled in this study: 51 patients in the TPE group and 40 patients in the TPE + IVIG/IVMP group. In the TPE group, the median age was 51.39 ± 15.34 years, and 64.71% were women. In the TPE + IVIG/IVMP group, the median age of the patients was 42.93 ± 16.56 years, and 75% were women. The infection rate in the TPE + IVIG/IVMP group was significantly higher than that in the TPE group (P < 0.05). Both the 28-day mortality and the length of ICU stay did not differ statistically between the two groups (P > 0.05).ConclusionThis study showed no benefit of combing IVIG/IVMP with TPE in improving the outcome of patients with severe SRDs, suggesting that IVIG/IVMP may not be necessary when used conjunction with TPE for the treatment of severe SRDs.https://www.frontiersin.org/articles/10.3389/fimmu.2024.1454691/fullsystemic rheumatologic diseasestherapeutic plasma exchangeintravenous immunoglobulinintravenous methylprednisolone pulsecritically ill patients |
| spellingShingle | Jing Guo Jing Guo Jing Guo Shuiwen Li Shuiwen Li Shuiwen Li Hao Xu Hao Xu Hao Xu Xinxin Wang Xinxin Wang Xinxin Wang Weiyuan Luo Weiyuan Luo Weiyuan Luo Jie Sun Jie Sun Jie Sun Jianhua Li Jianhua Li Jianhua Li Zhu Chen Zhu Chen Zhu Chen Guiyang Lu Guiyang Lu Guiyang Lu Xiaolong Huang Xiaolong Huang Xiaolong Huang Shiju Chen Shiju Chen Yaogui Ning Yaogui Ning Yaogui Ning Plasma exchange alone versus combination with intravenous immunoglobulin/methylprednisolone pulse therapy in severe systemic rheumatic diseases: a retrospective study Frontiers in Immunology systemic rheumatologic diseases therapeutic plasma exchange intravenous immunoglobulin intravenous methylprednisolone pulse critically ill patients |
| title | Plasma exchange alone versus combination with intravenous immunoglobulin/methylprednisolone pulse therapy in severe systemic rheumatic diseases: a retrospective study |
| title_full | Plasma exchange alone versus combination with intravenous immunoglobulin/methylprednisolone pulse therapy in severe systemic rheumatic diseases: a retrospective study |
| title_fullStr | Plasma exchange alone versus combination with intravenous immunoglobulin/methylprednisolone pulse therapy in severe systemic rheumatic diseases: a retrospective study |
| title_full_unstemmed | Plasma exchange alone versus combination with intravenous immunoglobulin/methylprednisolone pulse therapy in severe systemic rheumatic diseases: a retrospective study |
| title_short | Plasma exchange alone versus combination with intravenous immunoglobulin/methylprednisolone pulse therapy in severe systemic rheumatic diseases: a retrospective study |
| title_sort | plasma exchange alone versus combination with intravenous immunoglobulin methylprednisolone pulse therapy in severe systemic rheumatic diseases a retrospective study |
| topic | systemic rheumatologic diseases therapeutic plasma exchange intravenous immunoglobulin intravenous methylprednisolone pulse critically ill patients |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2024.1454691/full |
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