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Long-Term Therapy with Intravenous Immunoglobulin is Beneficial in Patients with Autoimmune Diseases

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Abstract

The objective of our study is to evaluate the clinical response, steroid-sparing and adverse affects of long-term intravenous immunoglobulin (IVIG) treatment for autoimmune diseases. Patients were recruited from the Rheumatology clinic. All patients fulfilled the ACR criteria for the appropriate autoimmune disease. Beneficial effects of IVIG therapy in systemic lupus erythematosus (SLE) patients were evaluated utilizing the SLEDAI score. Clinical remission in patients with other autoimmune diseases was evaluated by a rheumatologist. Data were retrieved retrospectively from an IVIG database (Excel program). Seventeen patients—SLE (n = 11) and other autoimmune diseases (n = 6)—received a high dose IVIG protocol monthly for 6 months, followed by therapy every 2–3 months. The patients received a mean of 7.9 courses/patient. The mean follow-up for long-term therapy was 30 months. The response to IVIG treatment was remission in 12 patients. Change in the SLEDAI score following IVIG therapy was significant (p < 0.05). In responders, IVIG harbored a significant steroid-sparing effect (p < 0.05). Mild and transient adverse effects persisted with long-term therapy in 50% of patients. Severe adverse effects (pulmonary embolism and seizures) occurred early in two patients with SLE and secondary anti-phospholipid syndrome. Long-term IVIG therapy is beneficial and carries a good safety profile for SLE and other autoimmune diseases.

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Abbreviations

ACL:

Anti-cardiolipin

AEs:

Adverse effects

APS:

Anti-phospholipid syndrome

AMI:

Acute myocardial infarction

CNS:

Central nervous system

HIV:

Human immunodeficiency virus

IVIG:

Intravenous immunoglobulins

PAN:

Polyarteritis nodosa

PE:

Pulmonary embolism

PSS:

Progressive systemic sclerosis

RA:

Rheumatoid arthritis

SLE:

Systemic lupus erythematosus

SLEDAI score:

SLE Disease Activity Index score

ACR:

American College of Radiology

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Authors and Affiliations

  1. Department of Medicine C, Wolfson Medical Center, POB 63, Holon, Israel

    Gisele Zandman-Goddard

  2. Medical and Health Science Center, University of Debrecen, Debrecen, Hungary

    Alexander Krauthammer

  3. Department of Medicine E, Meir Medical Center, Meir, Israel

    Yair Levy

  4. Rheumatology Unit, Sheba Medical Center, Sheba, Israel

    Pnina Langevitz

  5. Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Sheba, Israel

    Yehuda Shoenfeld

  6. Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel

    Gisele Zandman-Goddard, Yair Levy, Pnina Langevitz & Yehuda Shoenfeld

Authors
  1. Gisele Zandman-Goddard
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  2. Alexander Krauthammer
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  3. Yair Levy
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  4. Pnina Langevitz
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  5. Yehuda Shoenfeld
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Correspondence to Gisele Zandman-Goddard.

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Zandman-Goddard, G., Krauthammer, A., Levy, Y. et al. Long-Term Therapy with Intravenous Immunoglobulin is Beneficial in Patients with Autoimmune Diseases. Clinic Rev Allerg Immunol 42, 247–255 (2012). https://doi.org/10.1007/s12016-011-8278-7

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  • DOI: https://doi.org/10.1007/s12016-011-8278-7

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