Removal of sFlt-1 From Blood Aids Preeclampsia
Reduces sFLT-1 levels, protein/creatinine ratios, while prolonging pregnancy
MONDAY, Sept. 28, 2015 (HealthDay News) -- Selective removal of circulating soluble Fms-like tyrosine kinase-1 (sFlt-1) with an extracorporeal device seems to be safe and effective for treating women with very preterm preeclampsia, according to a pilot study published online Sept. 24 in the Journal of the American Society of Nephrology.
Ravi Thadhani, M.D., M.P.H., from Massachusetts General Hospital in Boston, and colleagues conducted an open pilot study to evaluate the safety and potential efficacy of therapeutic apheresis with a plasma-specific dextran sulfate column to remove circulating sFlt-1 in 11 pregnant women (20 to 38 years of age) with very preterm preeclampsia (23 to 32 weeks' gestation).
The researchers found that mean sFlt-1 levels were reduced by 18 percent, with simultaneous reductions of 44 percent in protein/creatinine ratios. Compared to 22 untreated contemporaneous preeclampsia controls, pregnancy continued longer in women treated once and multiple times (three days versus eight and 12 days, respectively). Withholding preapheresis antihypertensive therapy, saline prehydration, and reducing blood flow through the apheresis column were used to manage transient maternal BP reduction during apheresis. No adverse effects of apheresis were observed when comparing infants born prematurely to untreated women with and without preeclampsia (22 patients per group).
"Therapeutic apheresis reduced circulating sFlt-1 and proteinuria in women with very preterm preeclampsia and appeared to prolong pregnancy without major adverse maternal or fetal consequences," the authors write. "A controlled trial is warranted to confirm these findings."
Several authors disclosed financial ties to diagnostics companies, including Kaneka Corporation, which funded the study.