Selective plasmosorption of extracellular DNA and NETs in patients with difficult-to-treat rheumatoid arthritis (first clinical experience)

Rheumatoid arthritis (RA) associated with interstitial lung disease (RA-ILD) represents a distinct clinical and pathogenetic phenotype characterized by high inflammatory activity, seropositivity, and systemic manifestations. In recent years, increasing attention has been directed to the role of extracellular DNA and neutrophil extracellular traps (NETs) in RA pathogenesis. This report presents the first case of selective plasmosorption of extracellular DNA and NETs in a patient with RA-ILD. The therapy was associated with a decrease in joint pain and stiffness and improvement of general condition. Laboratory parameters were also monitored dynamically. This clinical case demonstrates the potential of DNA-containing structure plasmosorption as an adjunctive method to enhance the effect of therapy with biological disease modifying antirheumatic drugs in refractory RA.