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

Keith S. Kanik, Cheryl H. Yarboro, Yaakov Naparstek, Paul H. Plotz, Ronald L. Wilder

Research output: Contribution to journalArticle

Abstract

Objective. Treatment with high-dose (400 mg/kg/day) intravenous immunoglobulin (IVIg) shows benefit in many autoimmune diseases but is very expensive. Low-dose IVIg 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 IVIg in patients with treatment-refractory rheumatoid arthritis (RA). Methods. Twenty patients with active RA were recruited. Ten patients received IVIg and 10 received albumin. Study subjects were given 6 courses of either IVIg (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 IVIg 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 IV/g, as administered in this trial, does not show a therapeutic effect in patients with refractory RA.

Original languageEnglish (US)
Pages (from-to)1027-1029
Number of pages3
JournalArthritis and Rheumatism
Volume39
Issue number6
DOIs
StatePublished - Jun 1996
Externally publishedYes

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Passive Immunization
Intravenous Immunoglobulins
Rheumatoid Arthritis
Therapeutics
Albumins
Experimental Arthritis
Rheumatoid Factor
Blood Sedimentation
Arthralgia
Therapeutic Uses
Hepatitis C
Hepacivirus
C-Reactive Protein
Autoimmune Diseases
Joints
Placebos
Physicians
Polymerase Chain Reaction
Infection

ASJC Scopus subject areas

  • Immunology
  • Rheumatology

Cite this

Failure of low-dose intravenous immunoglobulin therapy to suppress disease activity in patients with treatment-refractory rheumatoid arthritis. / Kanik, Keith S.; Yarboro, Cheryl H.; Naparstek, Yaakov; Plotz, Paul H.; Wilder, Ronald L.

In: Arthritis and Rheumatism, Vol. 39, No. 6, 06.1996, p. 1027-1029.

Research output: Contribution to journalArticle

Kanik, Keith S. ; Yarboro, Cheryl H. ; Naparstek, Yaakov ; Plotz, Paul H. ; Wilder, Ronald L. / Failure of low-dose intravenous immunoglobulin therapy to suppress disease activity in patients with treatment-refractory rheumatoid arthritis. In: Arthritis and Rheumatism. 1996 ; Vol. 39, No. 6. pp. 1027-1029.
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