静脉注射免疫球蛋白治疗难治性类脂质渐进性坏死性血管病的疗效和安全性：一项系统评价
Efficacy and safety of intravenous immunoglobulin for treating refractory livedoid vasculopathy: a systematic review.
作者信息
Gao Yimeng, Jin Hongzhong
机构信息
Department of Dermatology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, China.
Department of Dermatology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, No.1 Shuaifuyuan, Dongcheng district, Beijing, 100730 China.
出版信息
Ther Adv Chronic Dis. 2022 May 22;13:20406223221097331. doi: 10.1177/20406223221097331. eCollection 2022.
INTRODUCTION
Intravenous immunoglobulin (IVIG) was reported to be the third most used monotherapy in livedoid vasculopathy (LV). There is currently a lack of randomized controlled clinical trials and no standardized therapeutic regimen for IVIG therapy in LV.
METHODS
We performed a systematic review of the efficacy and safety of IVIG in treating patients with LV using PubMed, Cochrane, and Embase databases.
RESULTS
Eighty LV patients from 17 articles were included, receiving IVIG therapy at a dose of 1-2.1 g/kg body weight every 4 weeks. The effective rate of IVIG therapy in LV patients was 95% (76/80) in published studies, showing a good clinical response for resolution of pain, skin ulcerations, and neurological symptoms, and reducing the dependence on glucocorticoids and immunosuppressive agents. IVIG therapy was well tolerated, and no severe adverse events were observed.
CONCLUSION
Overall, to a certain degree, IVIG is probably a safe and effective treatment alternative for refractory LV patients, which still need to be confirmed by large-scale randomized controlled clinical trials.
引言
静脉注射免疫球蛋白（IVIG）据报道是类脂质渐进性坏死性血管病（LV）中第三常用的单一疗法。目前缺乏随机对照临床试验，且LV的IVIG治疗尚无标准化治疗方案。
方法
我们使用PubMed、Cochrane和Embase数据库对IVIG治疗LV患者的疗效和安全性进行了系统评价。
结果
纳入了17篇文章中的80例LV患者，每4周接受一次剂量为1-2.1 g/kg体重的IVIG治疗。在已发表的研究中，IVIG治疗LV患者的有效率为95%（76/80），在缓解疼痛、皮肤溃疡和神经症状以及减少对糖皮质激素和免疫抑制剂的依赖方面显示出良好的临床反应。IVIG治疗耐受性良好，未观察到严重不良事件。
结论
总体而言，在一定程度上，IVIG可能是难治性LV患者的一种安全有效的治疗选择，这仍需通过大规模随机对照临床试验来证实。
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