Graham Hughes Lupus Research Laboratory, Lupus Research Unit, The Rayne Institute, Division of Women's Health, King's College London, UK.
Clin Exp Rheumatol. 2014 Jan-Feb;32(1):41-7. Epub 2013 Sep 12.
Some studies have shown efficacy of intravenous immunoglobulin (IVIG) in the treatment of systemic lupus erythematosus (SLE) but its use still lacks of confirmation in large cohorts.
This observational, retrospective, single-centre clinical study included 52 SLE patients who received at least one cycle of IVIG (400 mg/kg/day for 5 days) from January 2001 to February 2011. Twenty-seven SLE patients were treated with IVIG for active disease and concomitant infection, while 26 received the IVIG as resistant to standard therapy. The indications for IVIG in the SLE patients were mainly cutaneous, haematological, neuropsychiatric and heart involvements.
In patients with active disease and concomitant infections, the response to IVIG treatment was a complete remission (n=9), partial remission (n=8), and no response (n=8). We recorded any response (total or partial) in 17 out of 27 patients (62.96%). In patients with active disease refractory to standard therapy, the response to IVIG treatment was a complete remission (n=6), partial remission (n=12), and no response (n=8). We recorded any response (total or partial) in 18 out of 26 patients (69.23%). Seven of these patients relapsed after a mean time of 8.9 months (3-23 months).
In a long-term study in the largest published cohort of SLE patients, IVIG was found to be effective in selected manifestations such as haematological and cardiac involvement or when other therapeutic approaches are not available, such as in patients with active disease and concomitant infection.
一些研究表明,静脉注射免疫球蛋白(IVIG)在治疗系统性红斑狼疮(SLE)方面具有疗效,但在大规模队列中其应用仍缺乏确证。
本观察性、回顾性、单中心临床研究纳入了 52 例自 2001 年 1 月至 2011 年 2 月期间至少接受过一个疗程 IVIG(400mg/kg/天,连续 5 天)治疗的 SLE 患者。27 例 SLE 患者因活动性疾病伴发感染而接受 IVIG 治疗,26 例因对标准治疗耐药而接受 IVIG 治疗。SLE 患者接受 IVIG 治疗的适应证主要为皮肤、血液、神经精神和心脏受累。
在伴有活动性疾病和伴发感染的患者中,IVIG 治疗的反应为完全缓解(n=9)、部分缓解(n=8)和无反应(n=8)。我们在 27 例患者中的 17 例(62.96%)中记录到任何反应(完全或部分)。在对标准治疗耐药的活动性疾病患者中,IVIG 治疗的反应为完全缓解(n=6)、部分缓解(n=12)和无反应(n=8)。我们在 26 例患者中的 18 例(69.23%)中记录到任何反应(完全或部分)。这些患者中有 7 例在平均 8.9 个月(3-23 个月)后复发。
在对最大规模已发表的 SLE 患者队列进行的长期研究中,我们发现 IVIG 对某些表现有效,例如血液系统和心脏受累,或者在其他治疗方法不可用时有效,例如在伴有活动性疾病和伴发感染的患者中。