Intravenous immunoglobulins in dermatology. Part 2: clinical indications and outcomes

Forbat, Emily; Ali, FR; Al‐Niaimi, Firas

doi:10.1111/ced.13552

Cited by 8 publications

(9 citation statements)

References 27 publications

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“…Another feasible approach could be the use of intravenous immunoglobulins, which have shown remarkable efficacy in autoimmune bullous dermatoses and dermatomyositis and some data exist on the potential benefit for ND [241,242]. Remarkably, they are also used in the haematological setting to replace the pool of circulating immunoglobulins in patients with chemotherapy-induced hypogammaglobulinemia [243].…”

Section: Discussion and Concluding Remarksmentioning

confidence: 99%

Immune-Mediated Dermatoses in Patients with Haematological Malignancies: A Comprehensive Review

et al. 2020

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Haematological malignancies induce important alterations of the immune system, which account for the high frequency of autoimmune complications observed in patients. Cutaneous immune-mediated diseases associated with haematological malignancies encompass a heterogeneous group of dermatoses, including, among others, neutrophilic and eosinophilic dermatoses, autoantibody-mediated skin diseases, vasculitis and granulomatous dermatoses. Some of these diseases, such as paraneoplastic pemphigus, are associated with an increased risk of death; others, such as eosinophilic dermatoses of haematological malignancies, run a benign clinical course but portend a significant negative impairment on a patient's quality of life. In rare cases, the skin eruption reflects immunological alterations associated with an unfavourable prognosis of the associated haematological disorder. Therapeutic management of immune-mediated skin diseases in patients with haematological malignancies is often challenging. Systemic corticosteroids and immunosuppressive drugs are considered frontline therapies but may considerably augment the risk of serious infections. Indeed, developing a specific targeted therapeutic approach is of crucial importance for this particularly fragile patient population. This review provides an up-to-date overview on the immune-mediated skin diseases most frequently encountered by patients with onco-haematological disorders, discussing new pathogenic advances and therapeutic options on the horizon.

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Section: Discussion and Concluding Remarksmentioning

confidence: 99%

Immune-Mediated Dermatoses in Patients with Haematological Malignancies: A Comprehensive Review

et al. 2020

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“…Intravenous immunoglobulin (IVIG) is used for immunomodulatory therapy of several inflammatory disorders [32].…”

Section: Intravenous Immunoglobulinmentioning

confidence: 99%

Pemphigus Vulgaris: Present and Future Therapeutic Strategies

Didona

Paolino

Zenzo

et al. 2022

Dermatol Pract Concept

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Pemphigus vulgaris (PV) belongs to the group of autoimmune blistering diseases. PV can affect not only mucous membranes, but also the skin and it is characterized by serum IgG autoantibodies against desmoglein 1 and 3, two major components of desmosomes. The introduction of glucocorticoids improved dramatically the prognosis of patients affected by PV. However, long-term use of high dose corticosteroids and adjuvant steroid-sparing immunosuppressants can lead to several adverse events. Rituximab, a chimeric anti-CD20 monoclonal antibody, has been recently approved as in-label therapy for PV, leading to an improvement of the prognosis and higher remission rate. Furthermore, other anti B-cell therapies and several anti-CD20 biosimilars have been introduced in the clinical practice. We focused on present and future therapeutic approaches in PV

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“…However, adverse events increase with higher doses and may interfere with patient's quality of life. 3,6 The goal of therapy in the bullous diseases is to induce and maintain remission, as evidenced by the cessation of new vesicle and bullae formation and healing of old lesions. 3,8 Long-term therapy may be required in recalcitrant disease and may be associated with significant toxicities if corticosteroids or immunosuppressants are needed, particularly in elderly patients with bullous pemphigoid.…”

Section: Introductionmentioning

confidence: 99%

“…5 The immunomodulatory effects are complex and multifaceted, including increased catabolism of autoantibodies, inhibition in autoantibody function, and decrease in plasma inflammatory markers. 2,3,6 Optimal dosing varies but follows similar conventional weight-based approaches (300–400 mg/kg/month) as well as higher doses (2 g/kg over 2–5 days/month) in aggressive disease. 2,4,7 Adverse events can be mild (headaches, backaches, hives), severe (anaphylaxis, thromboembolism), and are usually infusion-related and self-limiting.…”

Section: Introductionmentioning

confidence: 99%

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Low-dose subcutaneous immunoglobulin is an effective treatment for autoimmune bullous skin disorders: A case report

Streu

Wiseman

Johnston

2020

SAGE Open Medical Case Reports

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Intravenous immunoglobulin is a recognized treatment in recalcitrant autoimmune bullous diseases. Infusions are administered monthly over 1–5 days in the hospital setting and associated with mild to severe infusion-related systemic effects, in part due to the high doses necessary to induce and achieve remission. We present a case series of four patients with bullous diseases treated successfully with low-dose subcutaneous IgG who achieved remission with maintenance therapy. Patient-administered smaller, more frequent doses of IgG into subcutaneous tissue more closely mimics the body’s own antibody production and produces a more stable serum trough level. Subcutaneous IgG is a novel treatment approach in bullous diseases which can induce a state remission.

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Intravenous immunoglobulins in dermatology. Part 2: clinical indications and outcomes

Cited by 8 publications

References 27 publications

Immune-Mediated Dermatoses in Patients with Haematological Malignancies: A Comprehensive Review

Immune-Mediated Dermatoses in Patients with Haematological Malignancies: A Comprehensive Review

Pemphigus Vulgaris: Present and Future Therapeutic Strategies

Low-dose subcutaneous immunoglobulin is an effective treatment for autoimmune bullous skin disorders: A case report

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