PMID- 11100022
OWN - NLM
STAT- MEDLINE
DCOM- 20010125
LR  - 20061115
IS  - 0190-9622 (Print)
IS  - 0190-9622 (Linking)
VI  - 43
IP  - 6
DP  - 2000 Dec
TI  - Analysis of current data on the use of intravenous immunoglobulins in management 
      of pemphigus vulgaris.
PG  - 1049-57
AB  - BACKGROUND: Systemic corticosteroids, with or without the addition of 
      immunosuppressive adjuvant agents, are frequently used in treating patients with 
      pemphigus vulgaris (PV). The severe, catastrophic, and potentially fatal side 
      effects of these agents highlight the need for the development of safe 
      alternatives for PV therapy. Intravenous immunoglobulin (IVIG) therapy has 
      recently been reported to be effective in the treatment of PV. OBJECTIVE: Our 
      purpose was to do a retrospective analysis of the available literature on the use 
      of IVIG in the treatment of PV. We also wished to determine whether the 
      cumulative evidence permits making preliminary conclusions regarding the 
      potential role of IVIG in the overall management of PV. METHODS: A review of the 
      English-language, peer-reviewed literature was conducted for reports on IVIG use 
      in treatment of PV. The available information on 21 patients was used to assess 
      different dimensions of clinical efficacy. RESULTS: A minimum dose of 2 g/kg per 
      cycle given at regular monthly intervals for a minimum of 3 cycles seems be 
      effective in inducing a rapid clinical remission in patients with severe, 
      recalcitrant PV. However, this should not be perceived as a "standard" dose. 
      Tapering and eventual discontinuation of other agents were possible in many 
      patients. Long-term follow-up was not provided to examine the influence of IVIG 
      on the clinical course of disease, its efficacy as monotherapy, and the benefit 
      of using it as maintenance therapy to keep the patient in prolonged clinical 
      remission. In 4 of the 21 patients (19%), use of IVIG was of no clinical benefit. 
      This failure of efficacy was primarily due to inadequate use. IVIG demonstrated 
      beneficial effect in 17 of 21 patients (81%). CONCLUSION: IVIG may be a safe and 
      effective agent in the management of severe, recalcitrant PV. Multicenter 
      controlled studies, using different dose regimens, with lengthy follow-up periods 
      are necessary to clearly define the emerging beneficial role of IVIG.
FAU - Engineer, L
AU  - Engineer L
AD  - Harvard School of Dental Medicine, Boston, MA 02215, USA.
FAU - Bhol, K C
AU  - Bhol KC
FAU - Ahmed, A R
AU  - Ahmed AR
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Am Acad Dermatol
JT  - Journal of the American Academy of Dermatology
JID - 7907132
RN  - 0 (Immunoglobulins, Intravenous)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Dose-Response Relationship, Drug
MH  - Drug Administration Schedule
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Immunoglobulins, Intravenous/*administration & dosage
MH  - Male
MH  - Middle Aged
MH  - Pemphigus/diagnosis/*drug therapy/epidemiology
MH  - Retrospective Studies
MH  - Sensitivity and Specificity
MH  - Severity of Illness Index
MH  - Survival Rate
MH  - Treatment Outcome
EDAT- 2000/12/02 11:00
MHDA- 2001/02/28 10:01
CRDT- 2000/12/02 11:00
PHST- 2000/12/02 11:00 [pubmed]
PHST- 2001/02/28 10:01 [medline]
PHST- 2000/12/02 11:00 [entrez]
AID - S0190-9622(00)38823-5 [pii]
AID - 10.1067/mjd.2000.108366 [doi]
PST - ppublish
SO  - J Am Acad Dermatol. 2000 Dec;43(6):1049-57. doi: 10.1067/mjd.2000.108366.