Long-term treatment with human immunoglobulin for antisynthetase syndrome-associated interstitial lung disease.
Citation: Respiratory Medicine. 154:6-11, 2019 Jul - Aug.PMID: 31176796Institution: MedStar Washington Hospital CenterDepartment: Medicine/Internal MedicineForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Immunoglobulins, Intravenous/tu [Therapeutic Use] | *Immunologic Factors/tu [Therapeutic Use] | *Lung Diseases, Interstitial/th [Therapy] | *Myositis/th [Therapy] | Administration, Intravenous | Adrenal Cortex Hormones/tu [Therapeutic Use] | Adult | Aged | Carbon Monoxide/me [Metabolism] | Female | Follow-Up Studies | Humans | Immunoglobulins, Intravenous/ae [Adverse Effects] | Immunosuppressive Agents/tu [Therapeutic Use] | Lung Diseases, Interstitial/co [Complications] | Lung Diseases, Interstitial/mo [Mortality] | Lung/pp [Physiopathology] | Male | Middle Aged | Myositis/co [Complications] | Myositis/mo [Mortality] | Prednisone/tu [Therapeutic Use] | Pulmonary Diffusing Capacity/de [Drug Effects] | Retrospective Studies | Treatment Outcome | Vital Capacity/de [Drug Effects]Year: 2019ISSN:- 0954-6111
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
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Journal Article | MedStar Authors Catalog | Article | 31176796 | Available | 31176796 |
BACKGROUND: Interstitial lung disease-associated antisynthetase syndrome (AS-ILD) carries significant morbidity and mortality. Corticosteroids and immunosuppressive drugs are the mainstay of treatment. Human immunoglobulin (IVIg), an immunomodulator without immunosuppressive properties, is effective in myositis but the evidence supporting its use in ILD is scarce.
CONCLUSIONS: IVIg may be a useful complementary therapy in active progressive AS-ILD but is associated with potential side effects. Fssssurther investigation is required to determine the value of IVIg as an initial treatment in AS-ILD.
Copyright (c) 2019. Published by Elsevier Ltd.
METHODS: Retrospective analysis of AS-ILD patients. Linear mixed models using restricted maximum likelihood estimation was used to estimate the change in lung function and corticosteroid dose over time.
OBJECTIVE: To describe clinical outcomes of AS-ILD patients receiving IVIg.
RESULTS: Data from 17 patients was analyzed. Median follow-up was 24.6 months. Fourteen patients had refractory disease. The mean percent-predicted forced vital capacity (FVC%) (p=0.048) and percent-predicted diffusing capacity of the lung for carbon monoxide (DLCO%) (p=0.0223) increased over time, while the mean prednisone dose (p<0.001) decreased over time. Seven patients achieved a >10% increase in FVC%, including two who used IVIg as initial treatment. Five patients showed a >10% increase in DLCO% and TLC%. Nine (53%) patients experienced side effects.
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