Dialysis for RA: Prosorba Column Therapy
by Nathan Wei, MD, FACP, FACR
Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.
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The Prosorba column, at one time, was considered a unique treatment for patients with RA who had failed all other conventional therapies.
The column is actually a filter that looks like an oil filter or soup can. The filter contains silica (sand-like material) and Protein A.
A patient has intravenous lines placed in both arms. One line leads out to the filter. A patient’s blood is pumped to a special machine that separates red blood cells from plasma. The plasma is then run through the Prosorba column.
the theory is this...destructive antibodies are removed from the plasma. The clean plasma is recombined with the red blood cells and the “good” blood is then returned to the patient via an intravenous line attached to the patient’s other arm. Almost like dialysis.
A patient receives one treatment a week for twelve weeks. Each treatment lasts about two hours.
Potential side effects include flu like symptoms, short term flare of arthritis, and possibly a drop in blood pressure. Patients taking blood pressure medicines called ACE inhibitors are particularly at risk for low blood pressure. Sometimes giving a patient extra fluid during the treatment can help prevent some of these side effects.
It may take several weeks to months to notice a benefit. Patients who do respond will generally experience relief lasting six to twelve months.
Prosorba column treatment may be repeated if effective.
Since Prosorba is available mainly in a hospital setting and many hospitals do not have experience with Prosorba, it is difficult to obtain for many patients.
Patients who probably shouldn’t receive Prosorba are patients with a history of significant heart disease or stroke, a history of blood clots, pregnant women, and people who are dependent on ACE inhibitors.
It is worthwhile trying in patients who have failed other therapies.
This last sentence is no longer correct. The Prosorba column is unavailable in most places. Its demise was due to the huge influx of biologic therapies which have rendered a cumbersome technology like Prosorba, obsolete.
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