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Plasma exchange for treating cryoglobulinemia: a descriptive analysis.
Summary
Plasmapheresis for cryoglobulinemia shows weak mechanistic support but lacks high-quality trials. Further research is needed to confirm its efficacy in treating this vasculitis.
Area of Science:
- Nephrology
- Rheumatology
- Immunology
Background:
- Cryoglobulinemia is a vasculitis affecting small-to-medium vessels.
- Plasmapheresis removes cryoglobulins, potentially reducing disease complications.
- Evidence for plasmapheresis efficacy in cryoglobulinemia requires review.
Purpose of the Study:
- To review medical literature from 1988-2008.
- To assess evidence supporting or refuting plasmapheresis for cryoglobulinemia.
- To evaluate the effectiveness of plasmapheresis in managing cryoglobulinemia.
Main Methods:
- Literature search of MEDLINE and Cochrane Central Register (1988-2008).
- Inclusion of studies with at least five patients.
- Analysis of 11 articles, including plasma exchange and cryofiltration studies.
Main Results:
- 156 patients were included across 11 studies.
- Eight studies focused on plasma exchange; two used cryofiltration.
- Outcome measures were often poorly defined, hindering analysis.
Conclusions:
- Plasma exchange is an accepted cryoglobulinemia treatment.
- No large randomized controlled trials exist comparing it to placebo or immunosuppressants.
- Evidence weakly supports plasmapheresis, primarily on mechanistic grounds.
