SSc Patients With Gastrointestinal Symptoms Benefit From IV Immunoglobulin Treatment

Patrícia Silva, PhD avatar

by Patrícia Silva, PhD |

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In a recent study presented during the European League Against Rheumatism Annual European Congress of Rheumatology, patients with gastrointestinal symptoms associated with systemic sclerosis may benefit from IV immunoglobulin therapy treatment.

For the study, Raja J. and colleagues recruited 15 patients with a diagnosis of systemic sclerosis (SSc) from the Royal Free Hospital in Kuala Lumpur. The mean age of the patients was of 47.3 years, and the mean disease duration was of 7 years. All patients received standard doses of immunosuppressants and proton pump inhibitors.

For a mean time of 2.3 years, patients received IV immunoglobulin therapy in a frequency of six infusions each week to four infusions each month. The assessment of lower and upper gastrointestinal symptoms was conducted with the Reflux Disease Questionnaire and the University of California – Los Angeles Scleroderma Clinical Trial Consortium Gastrointestinal Tract Instrument (UCLA-SCTC GIT) 2.0. The researchers also evaluated muscle strength with the Medical Research Council (MRC) Sum Score and also with the modified Rodnan Skin Score.

Results revealed that there was an improvement in gastroesophageal reflux disease intensity and frequency from baseline. There were also improvements in the Mean UCLA-SCTC GIT and the MRC Sum scores.

The results also showed a reduction in the levels of creatinine kinase from a mean 501.3 mc/L and median 192 mc/L to a mean 112 mc/L and median 77 mc/L. In addition, there was a reduction in the mean basal modified Rodnan skin score following treatment.

The results showed that the Duration of IV immunoglobulin was not associated with response status after treatment.

Systemic sclerosis (SSc) is a systemic connective tissue disease. Characteristics of systemic sclerosis include essential vasomotor disturbances; fibrosis; subsequent atrophy of the skin, subcutaneous tissue, muscles, and internal organs (eg, alimentary tract, lungs, heart, kidney, CNS); and immunologic disturbances accompany these findings.

The overall goal in primary immunodeficiency treatment is to restore a patient’s immune system, allowing him or her to maintain a normal life. Infections caused by PI require medications, such as antibiotics. The underlying source of the PI should be treated as a whole, to minimize or prevent severe and frequent infections and associated complications from occurring. Management should include an individualized, patient approach to treatment.

IVIg treatments are sterile, purified IgG solutions manufactured from a highly refined pool of human plasma. Products contain more than 95% IgG, which has intact Fc-dependent effector functions and only trace amounts of immunoglobulin A (IgA) or immunoglobulin M (IgM).