Plasmapheresis not an option in treating steroid-dependent asthma

NEW YORK (Reuters Health) – Despite reports that plasmapheresis benefits patients with steroid-dependent bronchial asthma, results of a new study by Norwegian researchers indicate that plasmapheresis offers no benefit to these patients.

In a crossover pilot trial, reported in the December issue of Allergy, Dr. Ivar Ellingsen and colleagues, from the Haukeland University Hospital, Bergen, randomly assigned four severely asthmatic patients in crossover fashion to plasmapheresis or placebo. During the trial, the researchers looked for changes in the peak expiratory flow symptom score, the use of beta-2 agonist, and the doses of systemic steroids.

Before being randomized the patients underwent an 8-week run-in period. Each treatment or placebo period lasted 10 days, and was followed by 8 to 26 weeks of follow-up.

Plasmapheresis treatment did not have a significant effect on any of the variables assessed by the Norwegian team. Since plasmapheresis costs about $1000 per day and the patient has to be immobilized during treatment, the benefit from plasmapheresis would have to be significant for it to be worthwhile, the researchers note.

Dr. Ellingsen and colleagues conclude that "circulating humoral factors seem to be of little importance for the maintenance of the established chronic inflammation in these patients. In view of the lack of benefit and the cost of treatment, plasmapheresis does not seem to be a potential alternative treatment in patients with steroid-dependent bronchial asthma."

Allergy 2001;56:1202-1205.

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