TY - JOUR
T1 - The steroid-sparing effect of intravenous immunoglobulin in patients with autoimmune diseases
AU - Zandman-Goddard, Gisele
AU - Krauthammer, Alex
AU - Shoenfeld, Yehuda
PY - 2007/9
Y1 - 2007/9
N2 - This review covers the major advances in the therapeutic potential of intravenous immunoglobulin (IVIg) as a steroid-sparing agent in autoimmune diseases utilizing a structured search of Medline (1992-2007). IVIg is a potent biological drug, utilized routinely for idiopathic thrombocytopenic purpura, Kawasaki's diseases, Guillain-Barre syndrome and dermatomyositis. In addition, however, IVIg is an adjunct second-line therapy in neuroimmunologic, infectious, dermatologic, hematologic, obstetric, autoimmune, inflammatory and idiopathic disorders. Compared with immunosuppressive agents administered routinely for systemic autoimmune diseases, IVIg is advantageous, owing to its few and transient minor adverse effects. Hence, it is logical to deliver IVIg with steroids as a sparing agent. All the published material on IVIg and its steroid-sparing effect was reviewed. Currently, there is insufficient evidence to confirm that IVIg has a significant steroid-sparing effect. Based on the available information, IVIg has the potential to act as a steroid-sparing agent in systemic lupus erythematosus and autoimmune blistering diseases, but its effect in other autoimmune diseases remains uncertain. Further investigation is warranted where this issue will be addressed as a primary endpoint and in controlled trials.
AB - This review covers the major advances in the therapeutic potential of intravenous immunoglobulin (IVIg) as a steroid-sparing agent in autoimmune diseases utilizing a structured search of Medline (1992-2007). IVIg is a potent biological drug, utilized routinely for idiopathic thrombocytopenic purpura, Kawasaki's diseases, Guillain-Barre syndrome and dermatomyositis. In addition, however, IVIg is an adjunct second-line therapy in neuroimmunologic, infectious, dermatologic, hematologic, obstetric, autoimmune, inflammatory and idiopathic disorders. Compared with immunosuppressive agents administered routinely for systemic autoimmune diseases, IVIg is advantageous, owing to its few and transient minor adverse effects. Hence, it is logical to deliver IVIg with steroids as a sparing agent. All the published material on IVIg and its steroid-sparing effect was reviewed. Currently, there is insufficient evidence to confirm that IVIg has a significant steroid-sparing effect. Based on the available information, IVIg has the potential to act as a steroid-sparing agent in systemic lupus erythematosus and autoimmune blistering diseases, but its effect in other autoimmune diseases remains uncertain. Further investigation is warranted where this issue will be addressed as a primary endpoint and in controlled trials.
UR - http://www.scopus.com/inward/record.url?scp=34648823394&partnerID=8YFLogxK
U2 - 10.1586/1744666X.3.5.773
DO - 10.1586/1744666X.3.5.773
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C2 - 20477027
AN - SCOPUS:34648823394
SN - 1744-666X
VL - 3
SP - 773
EP - 780
JO - Expert Review of Clinical Immunology
JF - Expert Review of Clinical Immunology
IS - 5
ER -