A review of high‐dose intravenous immunoglobulin (hdIVIg) in the treatment of the autoimmune blistering disorders

S Jolles - Clinical and experimental dermatology, 2001 - academic.oup.com
S Jolles
Clinical and experimental dermatology, 2001academic.oup.com
High‐dose intravenous immunoglobulin (hdIVIg) is being used increasingly for
dermatological indications. Its mode of action is via a number of proposed mechanisms and
it is not associated with the many side‐effects of steroids and other immunosuppressive
agents. The evidence for using hdIVIg in the treatment of autoimmune bullous disorders is
based on uncontrolled trials and case reports. However, there are now 62 reported patients
and this review aims to make a critical assessment of the current data. This has been …
Abstract
High‐dose intravenous immunoglobulin (hdIVIg) is being used increasingly for dermatological indications. Its mode of action is via a number of proposed mechanisms and it is not associated with the many side‐effects of steroids and other immunosuppressive agents. The evidence for using hdIVIg in the treatment of autoimmune bullous disorders is based on uncontrolled trials and case reports. However, there are now 62 reported patients and this review aims to make a critical assessment of the current data. This has been obtained from a Medline search of the English literature from 1966 to 2000 for pemphigus vulgaris, pemphigus foliaceus, bullous pemphigoid, pemphigoid gestationis, cicatricial pemphigoid, epidermolysis bullosa acquisita and linear IgA disease. Taken together hdIVIg was effective in 81% of the patients with blistering disease. Patients appear to be more likely to respond when hdIVIg is used as adjunctive therapy (91% response rate) than as monotherapy (56% response rate). hdIVIg may offer a safe potential therapeutic avenue for resistant cases of the autoimmune bullous disorders but should be further assessed using double‐blind placebo‐controlled trials.
Oxford University Press