|
Efficacy of high-dose intravenous immunoglobulin
therapy in Japanese patients with steroid-resistant polymyositis and
dermatomyositis.
Mod Rheumatol. 2008 Jan 25
Saito E, Koike T, Hashimoto H, Miyasaka N, Ikeda Y, Hara M, Yamada H, Yoshida T, Harigai M, Ichikawa Y; Additional members of the GB-0998 Study Group.
Department
of Rheumatology, Toho University Ohashi Medical Center, 2-17-6 Ohashi,
Meguro-ku, Tokyo, 153-8515, Japan,
This e-mail address is being protected from spambots. You need JavaScript enabled to view it
.
Intravenous
immunoglobulin (IVIG) therapy was administered to 15 patients who were
refractory to traditional steroid therapy [eight with polymyosis (PM),
seven with dermamyosis (DM)] to evaluate its efficacy. Serum creatine
kinase (CK) significantly decreased from week 1, and manual muscle test
scores (MMT) and activities of daily living (ADL) significantly
increased from week 2. Efficacy rates were 93.3% (14/15 patients) as
assessed using the MMT score, 80.0% (12/15 patients) using the ADL
score, and 100% (15/15 patients) using the serum CK level.
When changes
in the serum CK level over two four-week periods, one before IVIG
therapy (from week -4 to week 0) and one after IVIG therapy (from week
0 to week 4), were transformed to natural logarithms, the four-week
change after IVIG therapy was significantly greater than that before
IVIG therapy. The estimated duration of the serum CK level remaining
normal in 50% of the patients after IVIG therapy was 334.5 days.
Adverse reactions were observed in seven of 16 patients (43.8%) during
the study period, but none of the adverse reactions were considered to
be serious or required emergency treatment. In conclusion, the present
study indicates that IVIG therapy is effective for steroid-resistant
PM/DM.
|
