PMID- 26473632
OWN - NLM
STAT- MEDLINE
DCOM- 20160714
LR  - 20160226
IS  - 2326-5205 (Electronic)
IS  - 2326-5191 (Linking)
VI  - 68
IP  - 3
DP  - 2016 Mar
TI  - Intravenous Immunoglobulin as an Immunomodulating Agent in Antineutrophil 
      Cytoplasmic Antibody-Associated Vasculitides: A French Nationwide Study of 
      Ninety-Two Patients.
PG  - 702-12
LID - 10.1002/art.39472 [doi]
AB  - OBJECTIVE: Intravenous immunoglobulin (IVIG) represents a therapeutic alternative 
      in antineutrophil cytoplasmic antibody-associated vasculitides (AAV), but its 
      efficacy has been evaluated in only 2 small prospective trials. The aim of this 
      study was to evaluate the efficacy and safety of IVIG in patients with AAV. 
      METHODS: We conducted a nationwide retrospective study of patients who received 
      IVIG as immunomodulatory therapy for AAV. RESULTS: A total of 92 patients (mean 
      age 51 years) presenting with either granulomatosis with polyangiitis (Wegener's) 
      (68%), eosinophilic granulomatosis with polyangiitis (Churg-Strauss) (22%), or 
      microscopic polyangiitis (10%) received at least 1 course of IVIG. Antineutrophil 
      cytoplasmic antibodies were present in 72% during the flare that required IVIG, 
      as determined by immunofluorescence assay. IVIG was initiated because of 
      relapsing disease in 83% of cases. IVIG was given for a median of 6 months (range 
      1-156 months) and in combination with corticosteroids in 21% of the patients or 
      with other immunosuppressive agents in 77%. Efficacy of IVIG was assessed in the 
      entire population and in a subset of 34 patients with unmodified background 
      therapy. Remission rates at 6 months were 56% in the entire population and 58% in 
      the unmodified background therapy group. Refractory disease and treatment failure 
      at 6 months were observed in 7% and 18% in the whole population and 3% and 21% in 
      the unmodified background therapy group, respectively. Adverse events (AEs) 
      occurred in 33%, including serious AEs in 12% and AEs leading to discontinuation 
      of IVIG in 7%. CONCLUSION: This large study shows the clinical benefit of IVIG as 
      adjunctive therapy, with an acceptable tolerance profile, and thus supports its 
      use in AAV patients with refractory or relapsing disease.
CI  - (c) 2016, American College of Rheumatology.
FAU - Crickx, Etienne
AU  - Crickx E
AD  - National Referral Center for Rare Autoimmune and Systemic Diseases, Hopital 
      Cochin, AP-HP, and Universite Paris Descartes, Paris, France.
FAU - Machelart, Irene
AU  - Machelart I
AD  - Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France.
FAU - Lazaro, Estibaliz
AU  - Lazaro E
AD  - Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France.
FAU - Kahn, Jean-Emmanuel
AU  - Kahn JE
AD  - Hopital Foch, Suresnes, France.
FAU - Cohen-Aubart, Fleur
AU  - Cohen-Aubart F
AD  - Groupe Hospitalier Pitie Salpetriere, AP-HP, and Universite Pierre et Marie 
      Curie, Paris, France.
FAU - Martin, Thierry
AU  - Martin T
AD  - CHU de Strasbourg and National Referral Center for Rare Autoimmune and Systemic 
      Diseases, Strasbourg, France.
FAU - Mania, Alexandre
AU  - Mania A
AD  - CHU Gabriel-Montpied, Clermont-Ferrand, France.
FAU - Hatron, Pierre-Yves
AU  - Hatron PY
AD  - Centre Hospitalier Claude Huriez, Lille, France.
FAU - Hayem, Gilles
AU  - Hayem G
AD  - Hopital Ambroise Pare, AP-HP, Boulogne-Billancourt, France.
FAU - Blanchard-Delaunay, Claire
AU  - Blanchard-Delaunay C
AD  - Centre Hospitalier de Niort, Niort, France.
FAU - de Moreuil, Claire
AU  - de Moreuil C
AD  - CHU de Brest, Brest, France.
FAU - Le Guenno, Guillaume
AU  - Le Guenno G
AD  - CHU Estaing, Clermont-Ferrand, France.
FAU - Vandergheynst, Frederic
AU  - Vandergheynst F
AD  - Hopital Erasme, Brussels, Belgium.
FAU - Maurier, Francois
AU  - Maurier F
AD  - Hopitaux Prives de Metz, Metz, France.
FAU - Crestani, Bruno
AU  - Crestani B
AD  - Hopital Bichat, AP-HP, Paris, France.
FAU - Dhote, Robin
AU  - Dhote R
AD  - Hopital Avicenne, AP-HP, Bobigny, France.
FAU - Silva, Nicolas Martin
AU  - Silva NM
AD  - CHU de Caen, Caen, France.
FAU - Ollivier, Yann
AU  - Ollivier Y
AD  - CHU de Caen, Caen, France.
FAU - Mehdaoui, Anas
AU  - Mehdaoui A
AD  - Centre Hospitalier Intercommunal Eure et Seine, Evreux, France.
FAU - Godeau, Bertrand
AU  - Godeau B
AD  - Hopital Henri Mondor, AP-HP, Creteil, France.
FAU - Mariette, Xavier
AU  - Mariette X
AD  - Hopitaux Universitaires Paris-Sud, AP-HP, Universite Paris-Sud, Le 
      Kremlin-Bicetre, France.
FAU - Cadranel, Jacques
AU  - Cadranel J
AD  - Hopital Tenon, AP-HP, Paris, France.
FAU - Cohen, Pascal
AU  - Cohen P
AD  - National Referral Center for Rare Autoimmune and Systemic Diseases, Hopital 
      Cochin, AP-HP, and Universite Paris Descartes, Paris, France.
FAU - Puechal, Xavier
AU  - Puechal X
AD  - National Referral Center for Rare Autoimmune and Systemic Diseases, Hopital 
      Cochin, AP-HP, and Universite Paris Descartes, Paris, France.
FAU - Le Jeunne, Claire
AU  - Le Jeunne C
AD  - National Referral Center for Rare Autoimmune and Systemic Diseases, Hopital 
      Cochin, AP-HP, and Universite Paris Descartes, Paris, France.
FAU - Mouthon, Luc
AU  - Mouthon L
AD  - National Referral Center for Rare Autoimmune and Systemic Diseases, Hopital 
      Cochin, AP-HP, and Universite Paris Descartes, Paris, France.
FAU - Guillevin, Loic
AU  - Guillevin L
AD  - National Referral Center for Rare Autoimmune and Systemic Diseases, Hopital 
      Cochin, AP-HP, and Universite Paris Descartes, Paris, France.
FAU - Terrier, Benjamin
AU  - Terrier B
AD  - National Referral Center for Rare Autoimmune and Systemic Diseases, Hopital 
      Cochin, AP-HP, and Universite Paris Descartes, Paris, France.
CN  - French Vasculitis Study Group
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Arthritis Rheumatol
JT  - Arthritis & rheumatology (Hoboken, N.J.)
JID - 101623795
RN  - 0 (Antibodies, Antineutrophil Cytoplasmic)
RN  - 0 (Immunoglobulins, Intravenous)
RN  - 0 (Immunosuppressive Agents)
RN  - W980KJ009P (Corticosterone)
SB  - IM
CIN - Arthritis Rheumatol. 2016 Dec;68(12):3045-3046. PMID: 27588720
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/*drug therapy
MH  - Antibodies, Antineutrophil Cytoplasmic/blood
MH  - Churg-Strauss Syndrome/drug therapy
MH  - Corticosterone/administration & dosage
MH  - Female
MH  - Fluorescent Antibody Technique
MH  - Humans
MH  - Immune Tolerance
MH  - Immunoglobulins, Intravenous/administration & dosage/adverse 
      effects/*pharmacology
MH  - Immunomodulation
MH  - Immunosuppressive Agents/administration & dosage
MH  - Male
MH  - Microscopic Polyangiitis/drug therapy
MH  - Middle Aged
MH  - Remission Induction
MH  - Retrospective Studies
MH  - Treatment Failure
MH  - Treatment Outcome
MH  - Young Adult
EDAT- 2015/10/17 06:00
MHDA- 2016/07/15 06:00
CRDT- 2015/10/17 06:00
PHST- 2015/05/20 00:00 [received]
PHST- 2015/10/01 00:00 [accepted]
PHST- 2015/10/17 06:00 [entrez]
PHST- 2015/10/17 06:00 [pubmed]
PHST- 2016/07/15 06:00 [medline]
AID - 10.1002/art.39472 [doi]
PST - ppublish
SO  - Arthritis Rheumatol. 2016 Mar;68(3):702-12. doi: 10.1002/art.39472.