Intravenous immunoglobulins in systemic sclerosis: Data from a French nationwide cohort of 46 patients and review of the literature
Sébastien Sanges
(1, 2)
,
Sébastien Rivière
(3, 4)
,
Arsene Mekinian
(3, 4)
,
Thierry Martin
(5, 6)
,
Alain Le Quellec
(7)
,
Emmanuel Chatelus
(8, 9)
,
Alain Lescoat
(10)
,
Patrick Jégo
(10)
,
Claire Cazalets
(10)
,
Thomas Quemeneur
(11)
,
Noémie Le Gouellec
(11)
,
Patricia Senet
(12)
,
Camille Francès
(12)
,
Alban Deroux
(13)
,
Bernard Imbert
(13)
,
Olivier Fain
(3, 4)
,
Latifatou Boukari
(14)
,
Thomas Sené
(15)
,
Christophe Deligny
(16)
,
Alexis Mathian
(17, 4)
,
Christian Agard
(18)
,
Gregory Pugnet
(19, 20)
,
Silvia Speca
(1)
,
Sylvain Dubucquoi
(1)
,
Pierre-Yves Hatron
(1, 2)
,
Eric Hachulla
(1, 2)
,
David Launay
(1, 2)
1
LIRIC -
Lille Inflammation Research International Center - U 995
2 Service de médecine interne [Lille]
3 CHU Saint-Antoine [AP-HP]
4 UPMC - Université Pierre et Marie Curie - Paris 6 - UFR de Médecine Pierre et Marie Curie
5 CHU Strasbourg - Centre Hospitalier Universitaire [Strasbourg]
6 ICT - Immunopathologie et chimie thérapeutique
7 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
8 Service de rhumatologie [Strasbourg]
9 IRM - Immuno-Rhumatologie Moléculaire
10 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
11 Centre hospitalier [Valenciennes, Nord]
12 CHU Tenon [AP-HP]
13 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
14 Hôpital Jean Verdier [AP-HP]
15 Groupe Hospitalier Diaconesses Croix Saint-Simon
16 Hôpital Pierre Zobda-Quitman [CHU de la Martinique]
17 CHU Pitié-Salpêtrière [AP-HP]
18 Service de médecine interne [Nantes]
19 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
20 LEASP - Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps
2 Service de médecine interne [Lille]
3 CHU Saint-Antoine [AP-HP]
4 UPMC - Université Pierre et Marie Curie - Paris 6 - UFR de Médecine Pierre et Marie Curie
5 CHU Strasbourg - Centre Hospitalier Universitaire [Strasbourg]
6 ICT - Immunopathologie et chimie thérapeutique
7 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
8 Service de rhumatologie [Strasbourg]
9 IRM - Immuno-Rhumatologie Moléculaire
10 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
11 Centre hospitalier [Valenciennes, Nord]
12 CHU Tenon [AP-HP]
13 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
14 Hôpital Jean Verdier [AP-HP]
15 Groupe Hospitalier Diaconesses Croix Saint-Simon
16 Hôpital Pierre Zobda-Quitman [CHU de la Martinique]
17 CHU Pitié-Salpêtrière [AP-HP]
18 Service de médecine interne [Nantes]
19 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
20 LEASP - Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps
Arsene Mekinian
- Fonction : Auteur
- PersonId : 818189
- ORCID : 0000-0003-2849-3049
- IdRef : 131898493
Thierry Martin
- Fonction : Auteur
- PersonId : 1647
- IdHAL : thierry-martin
- IdRef : 170408108
Emmanuel Chatelus
- Fonction : Auteur
- PersonId : 1131883
- ORCID : 0000-0002-7360-6527
- IdRef : 110777069
Olivier Fain
- Fonction : Auteur
- PersonId : 1166060
- ORCID : 0000-0002-1974-3870
- IdRef : 069538476
Alexis Mathian
- Fonction : Auteur
- PersonId : 941137
- ORCID : 0000-0002-7653-6528
- IdRef : 10384371X
Christian Agard
- Fonction : Auteur
- PersonId : 1192626
- ORCID : 0000-0002-1156-0607
- IdRef : 068256752
Eric Hachulla
- Fonction : Auteur
- PersonId : 1366882
- ORCID : 0000-0001-7432-847X
- IdRef : 031788866
David Launay
- Fonction : Auteur
- PersonId : 1031611
Résumé
BACKGROUND:
As intravenous immunoglobulins (IVIG) exhibit immunomodulatory and antifibrotic properties, they may be a relevant treatment for systemic sclerosis (SSc). The objectives of this work were thus to report on the efficacy and safety of IVIG in a population of SSc patients and to review the available literature.
METHODS:
46 patients from 19 French centers were retrospectively recruited. They were included if they had a diagnosis of SSc and received at least 1 IVIG infusion at a dosage >1g/kg/cycle. Relevant data collected at IVIG discontinuation were compared to those collected at IVIG initiation. A comprehensive literature review was performed.
RESULTS:
We observed a significant improvement of muscle pain (74% vs. 20%, p<0.0001), muscle weakness (45% vs. 21%, p=0.01), joint pain (44% vs. 19%, p=0.02), CK levels (1069±1552UI vs. 288±449UI, p<0.0001) and CRP levels (13.1±17.6mg/L vs. 9.2±16.6mg/L, p=0.001). We also noted a trend for an improvement of gastro-esophageal reflux disease (68% vs. 53%, p=0.06) and bowel symptoms (42% vs. 27%, p=0.06). Skin and cardiorespiratory involvements remained stable. Finally, corticosteroid daily dose was significantly lower by the end of treatment (13.0±11.6mg/day vs. 8.9±10.4mg/day, p=0.01). Only two severe adverse events were reported (one case of deep vein thrombosis and one case of diffuse edematous syndrome).
CONCLUSION:
Our work suggests that IVIG are a safe therapeutic option that may be effective in improving musculoskeletal involvement, systemic inflammation, digestive tract symptoms and could be corticosteroid sparing.