Long-term follow-up of sporadic inclusion body myositis treated with intravenous immunoglobulin: a retrospective study of 16 patients

Clin Exp Rheumatol. 2012 Nov-Dec;30(6):838-42. Epub 2012 Dec 17.

Abstract

Objectives: Previous studies of intravenous immunoglobulin (IVIG) treatment in sporadic inclusion body myositis (sIBM) have yielded conflicting results. Here, we have undertaken a retrospective assessment of the long-term effects of IVIG in our sIBM cohort.

Methods: Sixteen sIBM patients, treated with a mean of 10 IVIG infusions and followed up for a mean period of 23 months, were identified. Six sIBM patients treated with other drugs were used as an internal control group. Serial data on manual muscle testing (MMT), laboratory parameters and patients' subjective assessment were collected.

Results: Serial MMT scores were available in 14 IVIG treated patients. Two of these patients improved more than 20% in MMT from baseline up to the third IVIG infusion. One of six patients in the control group showed a similar MMT improvement during the first six months. Improved swallowing function was reported by three IVIG-treated patients, but none of the controls. The serum levels of creatine kinase fell more than 20 % after the first IVIG infusion in 7/16 IVIG-treated patients, but this improvement was not sustained during the follow-up period.

Conclusions: IVIG treatment appears to have short-term beneficial effects on muscle strength and dysphagia in some few sIBM patients, but these effects are not sustained over time.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Chi-Square Distribution
  • Creatine Kinase / blood
  • Deglutition / drug effects
  • Deglutition Disorders / drug therapy
  • Deglutition Disorders / etiology
  • Deglutition Disorders / physiopathology
  • Female
  • Humans
  • Immunoglobulins, Intravenous / administration & dosage
  • Immunoglobulins, Intravenous / adverse effects
  • Immunoglobulins, Intravenous / therapeutic use*
  • Infusions, Intravenous
  • Male
  • Middle Aged
  • Muscle Strength / drug effects
  • Muscle, Skeletal / drug effects
  • Muscle, Skeletal / physiopathology
  • Myositis, Inclusion Body / complications
  • Myositis, Inclusion Body / diagnosis
  • Myositis, Inclusion Body / drug therapy*
  • Myositis, Inclusion Body / physiopathology
  • Recovery of Function
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome

Substances

  • Biomarkers
  • Immunoglobulins, Intravenous
  • Creatine Kinase