This article is more than 5 years old. Information may no longer be current.
Granulocyte, monocyte apheresis effectively treated generalized pustular psoriasis
Click Here to Manage Email Alerts
Granulocyte and monocyte apheresis therapy was effective and safe for patients with generalized pustular psoriasis, according to recent study results.
Researchers in Japan studied 15 patients (average age, 50.3 years; 11 men) who experienced persistent moderate to severe generalized pustular psoriasis (GPP) despite receiving conventional medications. Pustules affected more than 10% of the patients’ skin.
If initiated well in advance of the study start, treatment including oral etretinate, cyclosporine, methotrexate, prednisolone and topical prednisolone/vitamin D3 was maintained. Granulocyte and monocyte apheresis (GMA) therapy was administered once weekly for 5 weeks to selectively deplete myeloid lineage leukocytes. Skin covered by pustules at baseline and 2 weeks after the final GMA session were measured and compared to assess efficacy.
One patient did not complete the first GMA session because of an allergic reaction to an anticoagulant and withdrew from the study. For the remaining patients, overall GPP severity scores improved (P=.0027), based on results relative to entry, while areas of erythroderma (P=.0042), pustules (P=.0031), and edema (P=.0014) decreased. Dermatology Life Quality Index also improved (P=.0016).
Researchers classified 12 patients as responders, and 10 patients maintained clinical response for 10 weeks after their final GMA session while maintaining their medication regimen.
“The findings of this study indicate that activated myeloid lineage leukocytes are major pathologic factors in generalized pustular psoriasis,” the researchers concluded. “The elevated leukocytes can be normalized by granulocytapheresis.
“We believe that future studies should look at the number and the frequency of GMA sessions for optimum efficacy. … A combination of GMA and an anti-[tumor necrosis factor] potentially should produce better efficacy and be without some of the side effects seen with biologics in these clinical settings.”
Click Here to Manage Email Alerts