The therapeutic efficacy and safety of intravenous immunoglobulin in dermatomyositis and polymyositis: A systematic review and meta-analysis. 2023

Anji Xiong, and Yiying Qiang, and Yuzi Cao, and Yu Shuai, and Huini Chen, and Qilang Xiang, and Ziyi Hu, and Zhuoyao Song, and Shifeng Zhou, and Yan Zhang, and Hongxu Cui, and Ye Wang, and Jie Luo, and Shiquan Shuai, and Yuan Yang
Department of Rheumatology and Immunology, Nanchong Central Hospital, The Affiliated Nanchong Central Hospital of North Sichuan Medical College, Nanchong, China.

OBJECTIVE To evaluate the efficacy and safety of intravenous immunoglobulin (IVIG) in the treatment of dermatomyositis (DM) and polymyositis (PM). METHODS We searched PubMed, Embase, and the China National Knowledge Infrastructure for relevant studies from July 1919 to May 2021. RESULTS Seventeen papers pertinent to our questions were found: In a meta-analysis, we found that IVIG significantly improved the level of CK (SMD (STD. Mean Difference) = -0.69; 95%CI -0.93, -0.46; P < 0.0001), Manual Muscle Test (SMD = 1.12; 95%CI 0.77, 1.47; P < 0.00001), Medical Research Council (SMD = 1.59; 95%CI 0.86, 2.33; P < 0.00001), Activities of Daily Living (SMD = 1.07; 95%CI 0.59, 1.56; P < 0.0001). The CK levels in DM and PM were also significantly improved after IVIG (SMD = -0.73; 95%CI -1.12, -0.34; P = 0.0002 and SMD = -3.29; 95%CI -5.82, -0.76; P < 0.0001, respectively). The meta-analysis of three RCTs showed that there was a statistically significant improvement after IVIG (SMD = 0.63; 95%CI 0.22, 1.03; P = 0.002). In a random effects model, pooled muscle power improvement rate was 77% (95% CI: 66.0-87.0%). Meta-analyses of IVIG as first-line therapy showed a significant improvement of the CK level (SMD = -0.71; 95%CI -1.12, -0.30; P = 0.0007). The polled improvement rate of oesophageal disorders was 88% (95% CI: 80.0-95.0%). There was no statistically significant difference in the rate of improvement between the number of courses <2 and ≥2 (0.80% vs. 0.80%, P = 0.9). The proportion of corticosteroid-sparing success reached 81.8%. Adverse reactions following IVIG administration are usually mild and transient. Seven patients developed serious adverse events. CONCLUSIONS IVIG seems to be an effective drug for DM/PM, improving muscle strength, CK levels, and oesophageal involvement, and it is well tolerated by patients.

UI MeSH Term Description Entries
D003882 Dermatomyositis A subacute or chronic inflammatory disease of muscle and skin, marked by proximal muscle weakness and a characteristic skin rash. The illness occurs with approximately equal frequency in children and adults. The skin lesions usually take the form of a purplish rash (or less often an exfoliative dermatitis) involving the nose, cheeks, forehead, upper trunk, and arms. The disease is associated with a complement mediated intramuscular microangiopathy, leading to loss of capillaries, muscle ischemia, muscle-fiber necrosis, and perifascicular atrophy. The childhood form of this disease tends to evolve into a systemic vasculitis. Dermatomyositis may occur in association with malignant neoplasms. (From Adams et al., Principles of Neurology, 6th ed, pp1405-6) Polymyositis-Dermatomyositis,Dermatomyositis, Adult Type,Dermatomyositis, Childhood Type,Dermatopolymyositis,Juvenile Dermatomyositis,Juvenile Myositis,Adult Type Dermatomyositis,Childhood Type Dermatomyositis,Dermatomyositis, Juvenile,Myositis, Juvenile,Polymyositis Dermatomyositis
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000203 Activities of Daily Living The performance of the basic activities of self care, such as dressing, ambulation, or eating. ADL,Chronic Limitation of Activity,Limitation of Activity, Chronic,Activities, Daily Living,Activity, Daily Living,Daily Living Activities,Daily Living Activity,Living Activities, Daily,Living Activity, Daily
D000305 Adrenal Cortex Hormones HORMONES produced by the ADRENAL CORTEX, including both steroid and peptide hormones. The major hormones produced are HYDROCORTISONE and ALDOSTERONE. Adrenal Cortex Hormone,Corticoid,Corticoids,Corticosteroid,Corticosteroids,Cortex Hormone, Adrenal,Hormone, Adrenal Cortex,Hormones, Adrenal Cortex
D016756 Immunoglobulins, Intravenous Immunoglobulin preparations used in intravenous infusion, containing primarily IMMUNOGLOBULIN G. They are used to treat a variety of diseases associated with decreased or abnormal immunoglobulin levels including pediatric AIDS; primary HYPERGAMMAGLOBULINEMIA; SCID; CYTOMEGALOVIRUS infections in transplant recipients, LYMPHOCYTIC LEUKEMIA, CHRONIC; Kawasaki syndrome, infection in neonates, and IDIOPATHIC THROMBOCYTOPENIC PURPURA. Antibodies, Intravenous,Human Intravenous Immunoglobulin,IV Immunoglobulin,IVIG,Intravenous Antibodies,Intravenous Immunoglobulin,Intravenous Immunoglobulins,Alphaglobin,Endobulin,Flebogamma DIF,Gamimmune,Gamimmune N,Gamimune,Gamimune N,Gammagard,Gammonativ,Gamunex,Globulin-N,IV Immunoglobulins,Immune Globulin Intravenous (Human),Immune Globulin, Intravenous,Immunoglobulins, Intravenous, Human,Intraglobin,Intraglobin F,Intravenous IG,Intravenous Immunoglobulins, Human,Iveegam,Modified Immune Globulin (Anti-Echovirus Antibody),Privigen,Sandoglobulin,Venimmune,Venoglobulin,Venoglobulin-I,Globulin N,Human Intravenous Immunoglobulins,Immunoglobulin, Human Intravenous,Immunoglobulin, IV,Immunoglobulin, Intravenous,Immunoglobulins, Human Intravenous,Immunoglobulins, IV,Intravenous Immune Globulin,Intravenous Immunoglobulin, Human,Venoglobulin I
D017285 Polymyositis Diseases characterized by inflammation involving multiple muscles. This may occur as an acute or chronic condition associated with medication toxicity (DRUG TOXICITY); CONNECTIVE TISSUE DISEASES; infections; malignant NEOPLASMS; and other disorders. The term polymyositis is frequently used to refer to a specific clinical entity characterized by subacute or slowly progressing symmetrical weakness primarily affecting the proximal limb and trunk muscles. The illness may occur at any age, but is most frequent in the fourth to sixth decade of life. Weakness of pharyngeal and laryngeal muscles, interstitial lung disease, and inflammation of the myocardium may also occur. Muscle biopsy reveals widespread destruction of segments of muscle fibers and an inflammatory cellular response. (Adams et al., Principles of Neurology, 6th ed, pp1404-9) Myositis, Multiple,Polymyositis Ossificans,Polymyositis, Idiopathic,Idiopathic Polymyositides,Idiopathic Polymyositis,Multiple Myositis,Myositides, Multiple,Ossificans, Polymyositis,Polymyositides,Polymyositides, Idiopathic

Related Publications

Anji Xiong, and Yiying Qiang, and Yuzi Cao, and Yu Shuai, and Huini Chen, and Qilang Xiang, and Ziyi Hu, and Zhuoyao Song, and Shifeng Zhou, and Yan Zhang, and Hongxu Cui, and Ye Wang, and Jie Luo, and Shiquan Shuai, and Yuan Yang
April 2023, European journal of internal medicine,
Anji Xiong, and Yiying Qiang, and Yuzi Cao, and Yu Shuai, and Huini Chen, and Qilang Xiang, and Ziyi Hu, and Zhuoyao Song, and Shifeng Zhou, and Yan Zhang, and Hongxu Cui, and Ye Wang, and Jie Luo, and Shiquan Shuai, and Yuan Yang
May 2012, Clinical rheumatology,
Anji Xiong, and Yiying Qiang, and Yuzi Cao, and Yu Shuai, and Huini Chen, and Qilang Xiang, and Ziyi Hu, and Zhuoyao Song, and Shifeng Zhou, and Yan Zhang, and Hongxu Cui, and Ye Wang, and Jie Luo, and Shiquan Shuai, and Yuan Yang
July 1990, Lancet (London, England),
Anji Xiong, and Yiying Qiang, and Yuzi Cao, and Yu Shuai, and Huini Chen, and Qilang Xiang, and Ziyi Hu, and Zhuoyao Song, and Shifeng Zhou, and Yan Zhang, and Hongxu Cui, and Ye Wang, and Jie Luo, and Shiquan Shuai, and Yuan Yang
January 2024, Frontiers in immunology,
Anji Xiong, and Yiying Qiang, and Yuzi Cao, and Yu Shuai, and Huini Chen, and Qilang Xiang, and Ziyi Hu, and Zhuoyao Song, and Shifeng Zhou, and Yan Zhang, and Hongxu Cui, and Ye Wang, and Jie Luo, and Shiquan Shuai, and Yuan Yang
September 2022, Clinical rheumatology,
Anji Xiong, and Yiying Qiang, and Yuzi Cao, and Yu Shuai, and Huini Chen, and Qilang Xiang, and Ziyi Hu, and Zhuoyao Song, and Shifeng Zhou, and Yan Zhang, and Hongxu Cui, and Ye Wang, and Jie Luo, and Shiquan Shuai, and Yuan Yang
October 2002, Current rheumatology reports,
Anji Xiong, and Yiying Qiang, and Yuzi Cao, and Yu Shuai, and Huini Chen, and Qilang Xiang, and Ziyi Hu, and Zhuoyao Song, and Shifeng Zhou, and Yan Zhang, and Hongxu Cui, and Ye Wang, and Jie Luo, and Shiquan Shuai, and Yuan Yang
January 2002, Annals of the rheumatic diseases,
Anji Xiong, and Yiying Qiang, and Yuzi Cao, and Yu Shuai, and Huini Chen, and Qilang Xiang, and Ziyi Hu, and Zhuoyao Song, and Shifeng Zhou, and Yan Zhang, and Hongxu Cui, and Ye Wang, and Jie Luo, and Shiquan Shuai, and Yuan Yang
February 2022, Autoimmunity reviews,
Anji Xiong, and Yiying Qiang, and Yuzi Cao, and Yu Shuai, and Huini Chen, and Qilang Xiang, and Ziyi Hu, and Zhuoyao Song, and Shifeng Zhou, and Yan Zhang, and Hongxu Cui, and Ye Wang, and Jie Luo, and Shiquan Shuai, and Yuan Yang
October 2000, The Journal of rheumatology,
Anji Xiong, and Yiying Qiang, and Yuzi Cao, and Yu Shuai, and Huini Chen, and Qilang Xiang, and Ziyi Hu, and Zhuoyao Song, and Shifeng Zhou, and Yan Zhang, and Hongxu Cui, and Ye Wang, and Jie Luo, and Shiquan Shuai, and Yuan Yang
October 2014, Medicine,
Copied contents to your clipboard!