Safety and efficacy of high-dose leukocytapheresis in patients with refractory asthma

Abstract

Objective and design: An open-label, non-randomized, single-arm study was performed to investigate the safety and efficacy of high-dose leukocytapheresis (pulse LCAP) for refractory asthma.

Subjects: Six patients who fulfilled the ATS workshop criteria for refractory asthma were enrolled and completed this clinical study.

Treatment: After 4 weeks of observation, pulse LCAP using a large LCAP filter, Cellsorba(®) CS-180S, was performed twice with a 1-week interval at a target dose of 5 L per treatment session.

Methods: The clinical response was assessed by monitoring the peak expiratory flow rate (PEFR) twice a day. The asthma control test (ACT) was used to evaluate the condition of asthma symptoms. The fraction of exhaled nitric oxide (FeNO) as a biomarker for eosinophilic airway inflammation was measured using a chemiluminescence analyzer.

Results: PEFR in the morning or the evening and the sum total of the score on the ACT were increased after two consecutive sessions of pulse LCAP. FeNO decreased after pulse LCAP.

Conclusions: The results suggest the efficacy of pulse LCAP for refractory asthma.