Benefits of high-dose i.v. immunoglobulin in patients with severe steroid-dependent asthma.
OBJECTIVE
To determine the efficacy of IV immunoglobulin (IVIg) in severe asthma to reduce steroid requirements.


METHODS
Pre- and posttreatment measurements were analyzed using Dunnett's multiple comparison procedure.


METHODS
Hospital clinical research center.


METHODS
Eleven adolescents and adults with severe, steroid-dependent asthma enrolled over a 14-month period.


METHODS
IVIg was administered at a dose of 2 g/kg every 4 weeks for a total of seven infusions.


RESULTS
Steroid requirements, pulmonary function including lung volumes, symptom scores, bone densitometry, and airway reactivity monitored by methacholine challenge were followed over the course of 7 months. A significant decrease in steroid usage was achieved. Despite substantial steroid reduction, the patients demonstrated improvement in their pulmonary function and symptom scores. The responses to methacholine challenge were unaffected by IVIg treatment.


CONCLUSIONS
IVIg provides a potentially important adjunctive therapy in severe asthma, reducing oral steroid requirements and steroid side effects without deterioration of lung function.
Landwehr
L P
LP
Department of Pediatrics, National Jewish Medical and Research Center, Denver, CO 80206, USA.
Jeppson
J D
JD
Katlan
M G
MG
Esterl
B
B
McCormick
D
D
Hamilos
D L
DL
Gelfand
E W
EW
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D015519:Bone Density / Q000187:drug effects; D001985:Bronchial Provocation Tests; D002648:Child; D005260:Female; D005541:Forced Expiratory Volume; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage*; D007262:Infusions, Intravenous; D008297:Male; D016210:Methacholine Chloride; D008875:Middle Aged; D010366:Peak Expiratory Flow Rate; D014797:Vital Capacity
D005938:Glucocorticoids; D016756:Immunoglobulins, Intravenous; D016210:Methacholine Chloride