Failure of low-dose intravenous immunoglobulin therapy to suppress disease activity in patients with treatment-refractory rheumatoid arthritis

✍ Scribed by Keith S. Kanik; Cheryl H. Yarboro; Yaakov Naparstek; Paul H. Plotz; Ronald L. Wilder

• Publisher: John Wiley and Sons
• Year: 1996
• Tongue: English
• Weight: 262 KB
• Volume: 39
• Category: Article
• ISSN: 0004-3591
• DOI: 10.1002/art.1780390621

✦ Synopsis

Treatment with high-dose (400 mg/kg/ day) intravenous immunoglobulin ( M g ) shows benefit in many autoimmune diseases but is very expensive. Low-dose M g has also been shown to be effective in inhibiting adjuvant arthritis in the rat. This pilot, randomized, double-blind, placebo-controlled trial was conducted to assess the use of low-dose M g in patients with treatment-refractory rheumatoid arthritis (RA).

Methods. Twenty patients with active RA were recruited. Ten patients received M g and 10 received albumin. Study subjects were given 6 courses of either M g (5 mg/kg) or albumin (5 mg/kg), once every 3 weeks. Baseline medications were continued and not changed throughout the study.

Results. There were no complications. Five patients dropped out before the 18-week followup visit. No significant differences between treatment groups were noted during the 18-week trial in terms of global activity indices (patient or physician assessment), joint swelling, joint pain or tenderness, erythrocyte sedimentation rate, C-reactive protein level, or rheumatoid factor. The protocol was terminated prematurely because of reported contamination of M g by hepatitis C virus. None of the patients showed evidence of hepatitis C infection by serologic analysis or by polymerase chain reaction.

Conclusion.

Low-dose M g , as administered in this trial, does not show a therapeutic effect in patients with refractory RA.