Long-term i.v. Ig treatment in systemic lupus erythematosus.
OBJECTIVE
Treatment of SLE exacerbations with intravenous gammaglobulins has been shown to be safe and effective, leading to both clinical and serological improvement. In this study we test the hypothesis that intravenous immunoglobulins (IVIg), administered over a long period, would also be effective in patients with chronically active SLE.


METHODS
An open trial was carried out on 12 patients with SLE refractory to conventional treatments, administering monthly infusions of intravenous immunoglobulins at a dose of 400 mg/kg/day for 5 consecutive days. The therapy (400 mg/kg for 5 days) lasted from 6 up to 24 months.


RESULTS
Progressive clinical improvement was observed in 11 patients during the entire treatment course. This improvement was associated with an increase in hemoglobin, total serum hemolytic complement activity and C3 and C4 components, and in 2 thrombocytopenic patients in the platelet count, as well as a progressive reduction of ESR, serum immunocomplexes and antinuclear antibodies. A marked improvement in serum urea, creatinine clearance and proteinuria was also observed in those patients with renal involvement. We did not observe any adverse effects.


CONCLUSIONS
The results obtained suggest that IVIg therapy may be a promising option in the treatment of chronically active SLE; however, further evaluation of this therapy is essential.
Institute of Rheumatology, University of Siena, Italy.
C
C
Francioni
M
M
Galeazzi
A
A
Fioravanti
R
R
Gelli
F
F
Megale
R
R
Marcolongo
D000293:Adolescent; D000328:Adult; D000936:Antigen-Antibody Complex / Q000032:analysis; D005260:Female; D006801:Humans; D007136:Immunoglobulins / Q000032:analysis; D016756:Immunoglobulins, Intravenous / Q000009:adverse effects; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000627:therapeutic use; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome
D000936:Antigen-Antibody Complex; D007136:Immunoglobulins; D016756:Immunoglobulins, Intravenous; D008775:Methylprednisolone