GMA's Potential in Tackling Skin and Joint Issues in PPP with PAO

In Japan, a special treatment called Granulocyte and Monocyte Adsorptive Apheresis (GMA) has been used to help people with a specific skin condition called palmoplantar pustulosis (PPP) and a joint condition called pustulotic arthro-osteitis (PAO). It works by removing certain types of white blood cells from the blood. This treatment was first approved in Japan in 2012 for a similar skin condition. Some smaller studies had shown that GMA could help with both the skin and joint problems of PPP with PAO. So, a study was conducted at three different dermatology departments in Japan. It aimed to see if GMA could really help patients with these conditions. The study took place between 2017 and 2020 and included 14 patients. Most of them were women, with an average age of around 53 years. Most of the patients had been dealing with skin issues for about 4 years and joint problems for almost the same amount of time. The treatment involved five weekly sessions of GMA. The effects were measured before, after, and three months after the treatment. Out of the 14 patients, 12 finished all five sessions. Two had to stop due to side effects. For those who completed the treatment, 33% saw a big improvement in their skin symptoms right after the GMA sessions. At the 3-month follow-up, 70% of the patients had seen a significant improvement in their skin. As for the joint symptoms, 67% of patients showed remarkable improvement right after the treatment. And at the 3-month mark, 60% of the patients had seen a significant improvement in their joints. The study suggests that GMA could be a promising treatment for both the skin and joint issues in PPP with PAO. However, it is important to note that this study was observational and not a controlled trial. This means that more research is needed to fully understand the benefits and risks of GMA for these conditions. The study also highlights the challenges of conducting research on rare conditions. With only 14 patients, the results are promising but not definitive. Future studies with larger groups of patients and more controlled settings could provide more definitive answers. For now, GMA shows potential as a treatment option, but it is not a cure-all. Another important point to consider is the side effects. Two patients had to stop the treatment due to adverse events. This underscores the need for careful monitoring and consideration of individual patient needs.