PMID- 10329814
OWN - NLM
STAT- MEDLINE
DCOM- 19990608
LR  - 20190723
IS  - 0091-6749 (Print)
IS  - 0091-6749 (Linking)
VI  - 103
IP  - 5 Pt 1
DP  - 1999 May
TI  - Effect of intravenous immunoglobulin on steroid consumption in patients with 
      severe asthma: a double-blind, placebo-controlled, randomized trial.
PG  - 810-5
AB  - BACKGROUND: There is a significant group of patients with severe asthma who 
      require chronic use of systemic steroids for control of their disease. These 
      patients are at risk for severe side effects from oral steroids. Intravenous 
      immunoglobulin (IVIG) has immunomodulatory properties, and a few open-label 
      trials have suggested its possible benefit in individuals with severe asthma. 
      OBJECTIVE: This study was designed to assess the potential benefit of IVIG as a 
      steroid-sparing agent in patients with severe asthma. METHODS: Thirty-eight 
      immunocompetent steroid-requiring patients with severe asthma were randomly 
      enrolled in a double-blind, placebo-controlled trial of IVIG. RESULTS: Of the 38 
      patients enrolled, 28 patients completed the study. A significant reduction in 
      oral steroid requirement was observed in both the IVIG-treated (n = 16) and the 
      placebo-treated (n = 12) patients. Further exploration of the results showed that 
      IVIG, but not placebo, had a significant steroid-sparing effect in patients 
      requiring high doses of oral steroids (ie, >2000 mg in the year before the 
      study). Within this subgroup, IVIG treatment (n = 9) resulted in a significant 
      decrease in oral steroid requirement, with a median of 16.4 mg/day during the 
      pretreatment period to 3 mg/day during the treatment phase (P =. 0078). No 
      significant decrease in oral steroid requirement was observed in placebo-treated 
      patients (n = 8) within this subgroup. Objective and subjective parameters of the 
      patients' asthma were unchanged in spite of the steroid tapering achieved in the 
      group treated with IVIG. CONCLUSION: IVIG may be a useful steroid-sparing agent 
      in patients with severe asthma requiring high doses of oral steroids.
FAU - Salmun, L M
AU  - Salmun LM
AD  - Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
FAU - Barlan, I
AU  - Barlan I
FAU - Wolf, H M
AU  - Wolf HM
FAU - Eibl, M
AU  - Eibl M
FAU - Twarog, F J
AU  - Twarog FJ
FAU - Geha, R S
AU  - Geha RS
FAU - Schneider, L C
AU  - Schneider LC
LA  - eng
GR  - M01 RR02172/RR/NCRR NIH HHS/United States
GR  - T32 AI07306/AI/NIAID NIH HHS/United States
PT  - Clinical Trial
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - United States
TA  - J Allergy Clin Immunol
JT  - The Journal of allergy and clinical immunology
JID - 1275002
RN  - 0 (Immunoglobulins, Intravenous)
RN  - 0 (Steroids)
SB  - IM
MH  - Administration, Oral
MH  - Adolescent
MH  - Adult
MH  - Asthma/drug therapy/*metabolism
MH  - Child
MH  - Child, Preschool
MH  - Dose-Response Relationship, Drug
MH  - Female
MH  - Humans
MH  - Immunoglobulins, Intravenous/*pharmacology
MH  - Male
MH  - Steroids/administration & dosage/*metabolism
EDAT- 1999/05/18 00:00
MHDA- 1999/05/18 00:01
CRDT- 1999/05/18 00:00
PHST- 1999/05/18 00:00 [pubmed]
PHST- 1999/05/18 00:01 [medline]
PHST- 1999/05/18 00:00 [entrez]
AID - S0091-6749(99)70424-0 [pii]
AID - 10.1016/s0091-6749(99)70424-0 [doi]
PST - ppublish
SO  - J Allergy Clin Immunol. 1999 May;103(5 Pt 1):810-5. doi: 
      10.1016/s0091-6749(99)70424-0.