Treatment with intravenous immunoglobulins in systemic lupus erythematosus: a series of 52 patients from a single centre.

Objectives: Some studies have shown efficacy of intravenous immunoglobulin (IVIG) in the treatment of systemic lupus erythematosus (SLE) but its use still lacks of confirmation in large cohorts.

Methods: This observational, retrospective, single-centre clinical study included 52 SLE patients who received at least one cycle of IVIG (400 mg/kg/day for 5 days) from January 2001 to February 2011. Twenty-seven SLE patients were treated with IVIG for active disease and concomitant infection, while 26 received the IVIG as resistant to standard therapy. The indications for IVIG in the SLE patients were mainly cutaneous, haematological, neuropsychiatric and heart involvements.

Results: In patients with active disease and concomitant infections, the response to IVIG treatment was a complete remission (n=9), partial remission (n=8), and no response (n=8). We recorded any response (total or partial) in 17 out of 27 patients (62.96%). In patients with active disease refractory to standard therapy, the response to IVIG treatment was a complete remission (n=6), partial remission (n=12), and no response (n=8). We recorded any response (total or partial) in 18 out of 26 patients (69.23%). Seven of these patients relapsed after a mean time of 8.9 months (3-23 months).

Conclusions: In a long-term study in the largest published cohort of SLE patients, IVIG was found to be effective in selected manifestations such as haematological and cardiac involvement or when other therapeutic approaches are not available, such as in patients with active disease and concomitant infection.