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In each group 3 of 13 patients had improvements in strength and functional capacity.The condition of 3 patients treated with leukapheresis and 1 treated with plasma exchange deteriorated,and it was unchanged in the other 26 patients.Adverse effects of apheresis included the need for a central venous catheter(9 patients),major vasovagal episodes(3 patients), and severe citrate reactions(2 patients).Despite the occurrence of significant reductions in the serum levels of muscle enzymes with plasma exchange(P<0.001)and significant decreases in lymphocyte counts with leukapheresis(P=0.002),there were no significant differences among the three treatment groups in the final muscle strength or functional capacity of the patients.Conclusions.As treatments for corticosteroid-resistant polymyositis or dermatomyositis,leukapheresis and plasma exchange are no more effective than sham apheresis. |
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