Effect of intravenous immunoglobulin with or without cytotoxic drugs on pemphigus intercellular antibodies - 10/08/11
Abstract |
Background |
Intravenous immunoglobulin (IVIg)–a relatively new approach to treat pemphigus–lowers serum levels of pemphigus antibodies; however, the optimal way to use this agent is unknown.
Objective |
We sought to examine whether coadministration of a cytotoxic drug to patients with pemphigus improves the ability of IVIg to decrease serum levels of intercellular (IC) antibodies.
Methods |
In this retrospective study, we analyzed changes in IC antibody levels in 20 patients with pemphigus who were treated with 24 courses of IVIg administered alone (n = 10) or with a cytotoxic drug (n = 14). Each course of IVIg consisted of 400 mg/kg daily of immunoglobulin given over 5 days every other week; this cycle was repeated 3 to 4 times. Serum levels of IC antibodies were measured at baseline, before treatment, and 1 week and 1 month after the last IVIg cycle.
Results |
One week after the last IVIg cycle IC antibodies decreased by an average of 77% in the group treated with IVIg and cytotoxic drug compared with 48% in the group treated with IVIg alone (P = .54), and by 90% versus 43% 1 month later (P = .03).
Limitations |
A larger sample size is suggested for future studies.
Conclusions |
These observations confirm that IVIg can rapidly lower serum levels of autoantibodies in patients with pemphigus and its ability to do so is improved by the coadministration of a cytotoxic drug. These findings imply that the clinical effectiveness of IVIg in treating pemphigus, and possibly other autoantibody-mediated diseases, may be improved by the concurrent administration of a cytotoxic drug.
Le texte complet de cet article est disponible en PDF.Key words : azathioprine, cyclophosphamide, cytotoxic, immunofluorescence, immunoglobulin, intercellular antibodies, intravenous, pemphigus
Abbreviations used : AZA, CP, DSS, ELISA, IC, IV, IVIg
Plan
Supported in part by US Food and Drug Administration Grant No. 1R01FD-03343-01. |
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Conflicts of interest: None declared. |
Vol 64 - N° 3
P. 484-489 - mars 2011 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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