Intravenous immunoglobulin (IVIg) as adjuvant therapy for Wegener's granulomatosis

There is insufficient evidence that IVIg (intravenous immunoglobulin) adjuvant therapy provides an advantage compared with the combination of steroids and immunosuppressants for patients with Wegener's granulomatosis.

A Cochrane review included 1 study with a total of 34 subjects. The patients were randomly assigned to receive IVIg or placebo once daily in addition to azathioprine and prednisolone for remission maintenance. There were no significant differences between adjuvant IVIg and adjuvant placebo in mortality, serious adverse events, time to relapse, open-label rescue therapy, and infection rates. The fall in disease activity score, derived from patient-reported symptoms, was slightly greater in the IVIg group than in the placebo group at one month (MD 2.30; 95% CI 1.12 to 3.48, P < 0.01) and three months (MD 1.80; 95% CI 0.35 to 3.25, P = 0.01). There was a significant increase in total adverse events in the IVIg group (RR 3.50, 95% CI 1.44 to 8.48, P < 0.01).

Comment: The quality of evidence is downgraded by study limitations (unclear allocation concealment) and by imprecise results (few patients).

Ədəbiyyat

1. Fortin PM, Tejani AM, Bassett K et al. Intravenous immunoglobulin as adjuvant therapy for Wegener's granulomatosis. Cochrane Database Syst Rev 2013;(1):CD007057. .