LONG-TERM IV IG TREATMENT IN SYSTEMIC LUPUS-ERYTHEMATOSUS

Objective. Treatment of SLE exacerbations with intravenous gammaglobul ins has been shown to be safe and effective, leading to both clinical and serological improvement. In this study we test the hypothesis that intravenous immunoglobulins (IVIg), administered over a long period, would also be effective in patients with chronically active SLE. Desig n and patients. An open trial was carried out on 12 patients with SLE refractory to conventional treatments, administering monthly infusions of intravenous immunoglobulins at a dose of 400 mg/kg/day for 5 conse cutive days. The therapy (400 mg/kg for 5 days) lasted from 6 up to 24 months. Results. Progressive clinical improvement was observed in 11 patients during the entire treatment course. This improvement was asso ciated with an increase in hemoglobin, total serum hemolytic complemen t activity and C3 and C4 components, and in 2 thrombocytopenic patient s in the platelet count, as well as a progressive reduction of ESR, se rum immunocomplexes and antinuclear antibodies. A marked improvement i n serum urea, creatinine clearance and proteinuria was also observed i n those patients with renal involvement. We did not observe any advers e effects. Conclusion. The results obtained suggest that IVIg therapy may be a promising option in the treatment of chronically active SLE; however, further evaluation of this therapy is essential.