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Efficacy of high-dose intravenous immunoglobulin therapy in Japanese patients with steroid-resistant polymyositis and dermatomyositis

  • Original Article
  • Published:
Modern Rheumatology

An Erratum to this article was published on 25 March 2008

An Erratum to this article was published on 25 March 2008

Abstract

Intravenous immunoglobulin (IVIG) therapy was administered to 15 patients who were refractory to traditional steroid therapy [eight with polymyosis (PM), seven with dermamyosis (DM)] to evaluate its efficacy. Serum creatine kinase (CK) significantly decreased from week 1, and manual muscle test scores (MMT) and activities of daily living (ADL) significantly increased from week 2. Efficacy rates were 93.3% (14/15 patients) as assessed using the MMT score, 80.0% (12/15 patients) using the ADL score, and 100% (15/15 patients) using the serum CK level. When changes in the serum CK level over two four-week periods, one before IVIG therapy (from week −4 to week 0) and one after IVIG therapy (from week 0 to week 4), were transformed to natural logarithms, the four-week change after IVIG therapy was significantly greater than that before IVIG therapy. The estimated duration of the serum CK level remaining normal in 50% of the patients after IVIG therapy was 334.5 days. Adverse reactions were observed in seven of 16 patients (43.8%) during the study period, but none of the adverse reactions were considered to be serious or required emergency treatment. In conclusion, the present study indicates that IVIG therapy is effective for steroid-resistant PM/DM.

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Acknowledgments

We would like to express our gratitude to the members of the GB-0998 Study Group who are not listed as authors but have provided valuable advice and data for the present study. This work was supported by Mitsubishi Pharma Corporation.

Author information

Authors and Affiliations

  1. Department of Rheumatology, Toho University Ohashi Medical Center, 2-17-6 Ohashi, Meguro-ku, Tokyo, 153-8515, Japan

    Eizo Saito

  2. Department of Medicine II, Hokkaido University Graduate School of Medicine, Kita 15 Nishi 7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan

    Takao Koike

  3. Division of Rheumatology, Department of Internal Medicine, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan

    Hiroshi Hashimoto

  4. Department of Medicine & Rheumatology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan

    Nobuyuki Miyasaka

  5. Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan

    Yasuo Ikeda

  6. Institute of Rheumatology, Tokyo Women’s Medical University, 10-22 Kawadacho, Shinjuku-ku, Tokyo, 162-0054, Japan

    Masako Hara & Masayoshi Harigai

  7. Division of Rheumatology and Allergy, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-0015, Japan

    Hidehiro Yamada

  8. Department of Pathophysiology, Faculty of Pharmaceutical Science, Hoshi University, 2-4-41 Ebara, Shinagawa-ku, Tokyo, 142-8501, Japan

    Tadashi Yoshida

  9. St. Joseph’s Hospital, 28 Midorigaoka, Yokosuka, Kanagawa, 238-8502, Japan

    Yoichi Ichikawa

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  1. Eizo Saito
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  2. Takao Koike
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  4. Nobuyuki Miyasaka
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  5. Yasuo Ikeda
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  6. Masako Hara
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  7. Hidehiro Yamada
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  8. Tadashi Yoshida
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Additional members of the GB-0998 Study Group

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Correspondence to Eizo Saito.

Additional information

An erratum to this article can be found at http://dx.doi.org/10.1007/s10165-008-0050-3

Appendix: The list of additional members of the GB-0998 Study Group is given below

Appendix: The list of additional members of the GB-0998 Study Group is given below

  • Tatsuya Atsumi, MD; Yoshiharu Amasaki, MD; Akira Furusaki, MD; Yoshie Sakai, MD, Department of Medicine II, Hokkaido University Graduate School of Medicine

  • Tsutomu Takeuchi, MD; Koichi Amano, MD, Department of Internal Medicine, Saitama Medical Center, Saitama Medical School

  • Shigeto Kobayashi, MD; Yoshiaki Tokano, MD; Takeshi Yamaji, MD; Kazuhiko Kaneda, MD; Manami Seki, MD, Division of Rheumatology, Department of Internal Medicine, Juntendo University School of Medicine

  • Ryuji Koike, MD; Takahiko Sugihara, MD, Department of Medicine & Rheumatology, Tokyo Medical and Dental University

  • Michito Hirakata, MD; Akira Suwa, MD; Shinji Sato, MD; Misako Suzuki, MD, Section of Rheumatology, Department of Internal Medicine, Keio University School of Medicine

  • Mutsuto Tateishi, MD; Satomi Higami, MD; Naomi Ichikawa, MD, Institute of Rheumatology, Tokyo Women’s Medical University

  • Hiroshi Oka, MD, Division of Rheumatology and Allergy, Department of Internal Medicine, St. Marianna University School of Medicine

  • Jun Okada, MD; Akira Ishikawa, MD; Toshiya Hamana, MD, Division of Rheumatology and Infectious Disease, Kitasato University School of Medicine

  • Masatoshi Takaya, MD, Department of Internal Medicine, Division of Rheumatology, School of Medicine, Tokai University

  • Shunji Yoshida, MD; Hideo Yoshida, MD; Kenichi Kato, MD, Section of Rheumatology and Infectious Diseases, Department of Internal Medicine, Fujita Health University School of Medicine

  • Tsuneyo Mimori, MD; Hisanori Umehara, MD; Takao Fujii, MD; Hajime Yoshifuji, MD; Yoshimasa Fujita, MD, Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University

  • Yukihiko Saeki, MD, Department of Molecular Medicine, Osaka University Medical School

  • Kazuyoshi Saito, MD; Mikiko Tokunaga, MD, The First Department of Internal Medicine, University of Occupational and Environmental Health

  • Susumu Shirabe, MD, The First Department of Internal Medicine, Graduate School of Biochemical Sciences, Nagasaki University

  • Hitoaki Okazaki, MD, Division of Rheumatology and Clinical Immunology, Department of Medicine, Jichi Medical School

  • Kimihiro Suzuki, MD; Makoto Okada, MD, Internal Medicine I, National Defence Medical College

  • Shinichi Inada, MD; Takashi Ogasawara, MD, Division of Rheumatic Diseases, Tokyo Metropolitan Ohtsuka Hospital

  • Yasuo Matsuoka, MD, Department of Internal Medicine, Kawasaki Municipal Hospital

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Saito, E., Koike, T., Hashimoto, H. et al. Efficacy of high-dose intravenous immunoglobulin therapy in Japanese patients with steroid-resistant polymyositis and dermatomyositis. Mod Rheumatol 18, 34–44 (2008). https://doi.org/10.1007/s10165-007-0013-0

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