Background Therapeutic plasma exchange (TPE) offers an alternative therapeutic modality for patients with systemic lupus erythematosus (SLE) and primary antiphospholipid syndrome (APS). However, there is conflicting evidence regarding its efficacy in different sub-phenotypes.
Objectives This study aims to investigate the main clinical characteristics and outcomes of patients with different phenotypes of SLE and APS treated with TPE at a tertiary care centre.
Methods Database of Blood and Apheresis Unit between 2001–2013 was screened for patients with SLE and primary APS. SLE disease activity index (SELENA-SLEDAI), the indications for treatment, complications and outcomes were obtained from review of medical records and phone calls. A total of 24 patients (SLE: 20, APS: 4) were recruited for the study.
Results Mean ages of SLE (M/F: 1/19) and primary APS (PAPS) patients (M/F: 2/2) were 32.4±12.89 and 52.0±10.7, respectively. The main indications for TPE were haematologic, neurologic, pulmonary involvement and APS-related. TPE was preferred in 8 patients because of leukopenia, and co-infection. SLEDAI was significantly decreased after TPE (16.7±8.3 vs. 8.8±3.1, p=0.001). Both primary APS and SLE related CAPS patients had completely responded to TPE. Success rate of TPE in patients with thrombocytopenia were lower than patients with haemolytic anaemia. Median (IQR 25%>75%) TPE sessions were 6.5 (5–10.5).
Conclusions This study suggests catastrophic antiphospholipid syndrome (CAPS) and other APS related problems respond well to the TPE treatment. TPE should be kept in mind for the treatment of patients with other features of SLE, especially those resistant to other agents and in the presence of leukopenia and psychosis
Disclosure of Interest None declared