A controlled trial of plasmapheresis therapy in severe lupus nephritis
Article Abstract:
Plasmapheresis (plasma exchange) may be no more effective than standard therapy when treating patients with systemic lupus erythematosus and kidney disease. Systemic lupus erythematosus is an inflammatory connective tissue disease that can affect many organs. Of 86 patients with systemic lupus erythematosus and severe kidney disease, 40 received plasmapheresis and standard treatment with prednisone and cyclophosphamide, and 46 received standard treatment alone. Eight patients (20%) who underwent plasmapheresis and six patients (13%) who received standard treatment alone died. Kidney failure occurred in 10 patients (25%) in the plasmapheresis group, and eight patients (17%) in the standard treatment group. Sixteen patients (40%) who received plasmapheresis were unable to continue treatment, compared to 14 patients (30%) who received standard treatment alone. Sixteen patients (40%) in the plasmapheresis group experienced kidney disease remission, compared to 19 patients (41%) in the standard treatment group.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1992
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Desperate diseases and plasmapheresis
Article Abstract:
Plasmapheresis, or replacement of blood plasma, may not be an effective treatment for patients with chronic rheumatic diseases for whom other treatments have failed. Plasmapheresis is a procedure in which the substance that causes the disease is removed from patient's blood. It was originally developed for donation of certain blood components such as red blood cells, white blood cells, platelets or plasma. Plasmapheresis may cause complications, but rarely causes death. A research study found that lupus patients with severe kidney disease who were treated with plasmapheresis and corticosteroids did not go into remission more often than those treated with corticosteroids alone. Another study found that plasmapheresis was not effective in treating patients with the inflammatory disorders polymyositis and dermatomyositis. Treatment of these disorders with plasmapheresis may have failed for several reasons, but it is an effective treatment for other disorders.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1992
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A controlled clinical trial of dichloroacetate for treatment of lactic acidosis in adults
Article Abstract:
Dichloroacetate may not be an effective treatment for lactic acidosis in adults. Lactose acidosis is a disorder characterized by abnormal acid-base metabolism that occurs in individuals with other serious diseases. Among 252 patients with lactic acidosis whose blood levels of lactate were 5.0 millimoles per liter or more, 126 were treated with dichloroacetate and 126 received a placebo, or inactive substance. Blood levels of lactate dropped 20% or more in 83 patients (66%) treated with dichloroacetate and 45 (36%) who received a placebo. Fifteen patients (12%) treated with dichloroacetate survived to be discharged from the hospital compared to 21 (17%) who received a placebo.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1992
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