International Trends in Immunity

The aim of this retrospective study is to evaluate the efficacy and safety of intravenous immune globulin (IVIg) as immunomodulatory treatment in patients with inflammatory myopathies. We analyzed six patients, observed in a single-center from 2004 to 2012, affected by polymyositis (PM), dermatomyositis (DM) or inclusion body myositis (IBM) and treated with IVIg. IVIg has been successfully used as rescue therapy in all patients with a periodical dose of 1-2 g/Kg administered in 5 days. The mean follow-up was 37 months. Beneficial effects of IVIg were evaluated utilizing clinical notes, muscle enzyme levels and clinimetric score. All patients showed an improvement of muscle strength and a significant reduction of muscle enzyme levels (p<0.01 and p<0.05, respectively). Adverse events were mild and tolerable. Although IVIg has been demonstrated to be effective as steroid-sparing agent when other immunosuppressive drugs had failed, in all patients, however, a progressive reduction of clinical response after a variable number of IVIg cycles was observed. IVIg may safely be used and represents an effective rescue therapy in autoimmune myositis. Larger controlled studies are however needed to establish the IVIg actual efficacy in inflammatory myopathies, define standard therapeutic guidelines and detect predictive factors of response.