Analysis of High-dose Intravenous Immunoglobulin Therapy in 16 Patients with Refractory Autoimmune Blistering Skin Disease: High Efficacy and No Serious Adverse Events

Abstract

High-dose intravenous immunoglobulin (IVIG) therapy is used in patients with severe autoimmune blistering diseases that are refractory to standard immunosuppressive therapy. To determine the efficacy and frequency of adverse events of IVIG therapy, we retrospectively analysed data for 16 patients with pemphigus vulgaris, pemphigus foliaceus, paraneoplastic pemphigus, bullous pemphigoid and paraneoplastic bullous pemphigoid. Frequency of adverse reactions and efficacy of IVIG were analysed over time with a scoring system for every 6 months of IVIG therapy. Headache (43.8%) and fatigue (43.8%) were the most common side-effects recorded; serious adverse reactions did not occur. There was good overall efficacy, as measured by clinical response rates using a clinical score, as well as indicated by a mean reduction of 75.8% in the starting steroid dose.

Comparison of high‐dose intravenous immunoglobulin (IVIG) in a 5% and a 10% solution does not reveal a significantly different spectrum of side‐effects

“…Comparison of high-dose intravenous immunoglobulin (IVIG) in a 5% and a 10% solution does not reveal a significantly different spectrum of side-effects Editor High-dose intravenous immunoglobulins (IVIG) have been shown to be very efficient in severe autoimmune disease after primary treatment failure of immunosuppressive therapy with steroids and immunosuppressants, or relapse after initial response. [1][2][3] Especially for autoimmune vesicobullous diseases (pemphigus vulgaris and bullous pemphigoid) as well as for dermatomyositis IVIG are a well-accepted second-line treatment. 3,4 IVIG are regarded as a safe therapy with little side-effects.…”

“…[1][2][3] Especially for autoimmune vesicobullous diseases (pemphigus vulgaris and bullous pemphigoid) as well as for dermatomyositis IVIG are a well-accepted second-line treatment. 3,4 IVIG are regarded as a safe therapy with little side-effects. In a retrospective study, we had already analysed the adverse effects in 16 patients receiving IVIG for treatment of vesiculobullous autoimmune diseases 3 : The most common adverse reactions were headache and fatigue (43.8% both).…”

Pemfigusta Konvansiyonel Olmayan Tedavi Yaklaşımları

“…Seidling ve arkadaşları yakın zamanda yaptıkları retrospektif bir çalışmada pemfigus vulgaris, pemfigus foliaseus, paraneoplastik pemfigus ve büllöz pemfigoid gibi çeşitli formlarda otoimmün büllöz hastalığı bulunan 16 hastada IVIG tedavisinin etkinliğini ve güvenirliğini incelemişlerdir. Baş ağrısı ve baş dönmesi dışında hiçbir hastada ciddi bir yan etki izlenmemiş belirgin klinik iyileşme sağlanırken steroid dozu ortalama %75 civarında azaltılabilmiştir (9). IVIG tedavisi konvansiyonel tedavilere dirençli pemfigus hastalarında hem adjuvan olarak hem de tedavinin idame ettirilmesinde iyi bir alternatif gibi görünmektedir.…”

“…B hücrelerindeki azalmayı takip etmek için son infüzyondan sonra her üç ayda bir kan sayımı yapılması önerilmektedir. Nötrofil sayısı 1.5x 10 9 /l ve/veya trombosit sayısı 75x10 9 /l olan hastalarda ritüksimab tedavisi dikkatli bir şekilde sürdürülmelidir (25). …”

Immunoglobulin G promotes skin graft acceptance in an immunologically potent rat model

“…Intravenous immunoglobulin (IVIG) which is prepared from the plasma of a thousand or more blood donors was initially shown to be effective in treating acute idiopathic thrombocytopenic purpura (ITP) in 1981 [2]. From then on, IVIG has been used to treat different kinds of illnesses including immunodeficiency [3], autoimmune and inflammatory diseases [4], neurologic diseases [5], severe autoimmune blistering diseases [6] etc with little side effects.…”