Intravenous Immunoglobulins as Immunomodulators in Autoimmune Diseases and Reproductive Medicine

Abstract

Intravenous administration of immunoglobulins has been routinely used for more than 60 years in clinical practice, developed initially as replacement therapy in immunodeficiency disorders. Today, the use of intravenous immunoglobulins (IVIGs) is embedded in the modern algorithms for the management of a few diseases, while in most cases, their application is off-label and thus different from their registered therapeutic indications according to the summary of product characteristics. In this review, we present the state-of-the-art use of IVIGs in various autoimmune conditions and immune-mediated disorders associated with reproductive failure, as approved therapy, based on indications or off-label. IVIGs are often an alternative to other treatments, and the administration of IVIGs continues to expand as data accumulate. Additionally, new insights into the pathophysiology of immune-mediated disorders have been gained. Therefore, the need for immunomodulation has increased, where IVIG therapy represents an option for stimulating, inhibiting and regulating various immune processes.

Immunomodulatory Treatment Impact on IVF Outcomes in KIR AA Genotype: Personalized Fertility Insights

“…There are studies that have presented the benefits of prednisone on the uterine environment and showed the impact on the receptivity. Prednisone or prednisolone are often prescribed to suppress immune activity and reduce inflammation, potentially creating a more favorable environment for implantation [ 23 , 24 , 25 , 26 , 27 , 28 ].…”

Impact of Treatment with Ustekinumab on Severe Infections in a Patient with Uncontrolled Psoriasis and Late-Onset Combined Primary Immunodeficiency: Case Report

“…For our patient, treatment with ustekinumab and the possibility of monthly subcutaneous replacement with immunoglobulin was a turning point in his life, with improvements in his skin psoriasis, psoriatic arthritis, and Crohn’s disease as well as infectious disease control. Furthermore, the beneficial effect that immunoglobulin replacement has on autoimmune diseases is well documented, decreasing their intensity and modulating their activity [ 14 , 15 ]. In 2017, when he started ustekinumab, a broad range of literature was available on its effects in triggering infectious diseases in healthy individuals [ 7 , 8 , 16 , 17 ], however, as far as we know, no literature was available on combined primary immunodeficient patients.…”

Novel and potential future therapeutic options in systemic autoimmune diseases

“…There are some positive and promising experiences with the offlabel use of intravenous immunoglobulin (IVIG) therapy in refractory SLE patients; however, controlled trials are needed to define its potential role in the treatment of SLE (87).…”