Intravenous immunoglobulin therapy in systemic onset juvenile rheumatoid arthritis: A followup study

Yosef Uziel, Ronald M. Laxer, Rayfel Schneider, Earl D. Silverman*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objective. To report the short and longterm effect of intravenous immunoglobulin (IVIG) in patients with systemic onset juvenile rheumatoid arthritis (SOJRA). Methods. A retrospective chart review of 27 patients with SOJRA treated with IVIG and followed for 37.1 ± 18.2 months was undertaken. Indications for treatment were fever, arthritis, or steroid dependency. Results. We treated 27 patients with SOJRA with IVIG monthly for 3-54 months. Six months after IVIG therapy, 20 patients had at least a 50% decrease in at least one of the following: the number of days of fever; prednisone dose; or the number of active joints. Five patients failed to respond to IVIG, and 2 dropped out after 3 and 4 months. At last followup visit (mean 37.6 ± 18 months), 11 of the initial 20 responder group patients were in remission, while 3 had significantly improved but still had active arthritis, and 6 were now unresponsive. Of the initial 5 patients in the nonresponder group, 4 had nonresponsive arthritis and 1 had improved at last followup. Three patients in the responder group subsequently developed other diseases. Conclusion. The main benefit of IVIG therapy to most of our patients was a significant improvement in the systemic features, with resolution of fever and a significant reduction in the steroid dose. The efficacy of IVIG in altering the course of arthritis was less predictable. We suggest that IVIG has a role in the management of SOJRA, but it should be limited to patients with severe SOJRA in whom prolonged unresponsiveness to standard therapy is present.

Original languageEnglish
Pages (from-to)910-918
Number of pages9
JournalJournal of Rheumatology
Volume23
Issue number5
StatePublished - May 1996
Externally publishedYes

Keywords

  • Intravenous immunoglobulins
  • Juvenile rheumatoid arthritis
  • Systemic onset

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