Low dose intravenous immunoglobulin in addition to cyclophosphamide in systemic sclerosis

Systemic sclerosis: one year in review 2022

“…Agostini et al reported a significant decrease in mRSS at 6 months of followup and a stabilization after one year in 24 patients with refractory dcSSc treated with immunoglobulins (IVIg) (97). Perkovic et al recently reported complete resolution of DUs, a reduction in mRSS, and an improvement of DLco in a population of SSc patients after adding IVIg to CYC (98).…”

“…• Recent studies reported a more significant decrease in mRSS in patients treated with tofacitinib (95,96). Intravenous immunoglobulins (IVIg) provide promising results in the treatment of skin involvement (97,98).…”

Treatment of digital ulcers in systemic sclerosis: recent developments and future perspectives

“…Other treatments that were found to be effective in DU management include low-dose immune globulin and oral psoralen plus ultraviolet A therapy [ 68 , 69 ]. The above investigational agents are summarised in Table 2 .…”

“… Fernández-Codina et al/2020 [ 67 ] Retrospective observational study dSSc: 5, lSSc: 7, sine: 1 135 N/A 13 10 mg tadalafil cream 2×d. as add-on to standard treatment for 4 weeks Reduction of DU number close to statistical significance Perkovic et al/2020 [ 68 ] Retrospective observational study Diffuse: 8, limited: 1 9 N/A 6 IVIG Complete DU healing Inoue T et al/2014 [ 69 ] Case report dSSc 1 N/A 1 PUVA 3 times/week for 4 weeks, cumulative dose 23 J/cm 2 Ulcer healing and MRSS improvement from 32 to 15. ESWT extracorporeal shock wave therapy, HBOT hyperbaric oxygen therapy, dSSc diffuse SSc, lSSc limited SSc D4: a full-thickness skin lesion, > 3 mm in maximal diameter, with loss of epithelisation, epidermis and dermis D5: a loss of epithelisation and tissue, involving in different degrees the epidermis, the dermis, the subcutaneous tissue and sometimes also involving the bone D6: a break in the skin with a loss of epithelisation on the distal finger surface of ischaemic origin according to the physician and not located over subcutaneous calcifications or over extensor surfaces of joints.…”