Immunoadsorption therapy for dilated cardiomyopathy using tryptophan column-A prospective, multicenter, randomized, within-patient and parallel-group comparative study to evaluate efficacy and safety

Journal of Clinical Apheresis
Tsutomu YoshikawaHitonobu Tomoike

Abstract

Over the past few decades, several cardiac autoantibodies have been reported in sera from patients with dilated cardiomyopathy (DCM). Immunoadsorption (IA) therapy is one of the therapeutic tools to remove such autoantibodies. The objective of this study was to investigate functional effects of IA therapy using a tryptophan column in severe DCM patients. Of 49 patients enrolled, 44 were randomized from 10 sites in Japan. IA therapy was conducted in 40 patients with DCM (refractory to standard therapy for heart failure, New York Heart Association [NYHA] class III/IV, left ventricular ejection fraction [LVEF] <30%). Mean echocardiographic LVEF was significantly improved (23.8 ± 1.3% to 25.9 ± 1.3%, P = 0.0015). However, mean radionuclide LVEF over 3 months of IA therapy was not significantly improved (20.8 ± 1.1% to 21.9 ± 1%, P = 0.0605). The cardiothoracic ratio was also significantly decreased (P = 0.0010). NYHA functional class (P < 0.0001), subjective symptoms assessed by a quality of life questionnaire (P = 0.0022), maximum oxygen consumption (P = 0.0074), and 6-minute walk distance (P = 0.0050) were improved after IA therapy. Subgroup analysis revealed improvement of echocardiographic LVEF in patients with higher baseline ...Continue Reading

References

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Citations

Feb 7, 2017·Autoimmunity Reviews·Niels-Peter BeckerIngolf Schimke
Jan 21, 2020·Circulation. Heart Failure·Hans-Dirk DüngenJaved Butler
Jan 31, 2020·Dimensions of Critical Care Nursing : DCCN·Oksana Narovlyanskaya, Elizabeth J Winokur
Jul 5, 2017·Chemical & Pharmaceutical Bulletin·Atsushi MaharaTetsuji Yamaoka
Mar 16, 2018·Current Treatment Options in Cardiovascular Medicine·Paulino Alvarez, Alexandros Briasoulis
May 12, 2016·Current Opinion in Rheumatology·Noel R Rose

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BETA
biopsy

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SAS

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