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Experience of intravenous immunoglobulin therapy in neuropathy associated with primary Sjögren's syndrome: A national multicentric retrospective study
Author(s) -
Rist Stéphanie,
Sellam Jérémie,
Hachulla Eric,
Sordet Christelle,
Puéchal Xavier,
Hatron Pierreyves,
Benhamou Claudelaurent,
Sibilia Jean,
Mariette Xavier
Publication year - 2011
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.20495
Subject(s) - medicine , peripheral neuropathy , prednisone , retrospective cohort study , intravenous immunoglobulin therapy , gastroenterology , surgery , antibody , diabetes mellitus , immunology , endocrinology
Abstract Objective Sjögren's syndrome (SS)–related peripheral neuropathy is responsible for disability, but no treatment has been shown to improve its outcome. In some cases, intravenous immunoglobulin (IVIG) therapy has been associated with some benefit. In this study, we investigated the effectiveness of IVIG in SS‐related peripheral neuropathy. Methods We assessed the efficacy and tolerance of IVIG in 19 patients with primary SS–related neuropathy without any necrotizing vasculitis in a retrospective national multicentric study. The evaluation of the response was assessed using the disability Modified Rankin Scale (MRS) and a global evaluation by the practitioner. Results Eight patients (42%) exhibited a decrease of the MRS score corresponding to a clinical improvement, 10 patients (52%) exhibited a stable MRS score, and 1 patient (6%) showed an increase of MRS score. According to the global evaluation by the practitioner, 9 (47%) of the 19 patients were improved, 6 patients (31%) were stable, and 4 patients (21%) worsened. All the patients with sensorimotor (n = 5) or nonataxic sensory neuropathy (n = 4) were improved or stabilized. However, among the patients with ataxic neuropathy (n = 9), only 2 improved and 4 worsened. Ten of the 13 patients treated with corticosteroids could have had the prednisone dosage decreased from 15 mg/day (range 7.5–60) to 10 mg/day (range 5–20) with IVIG. Only 1 patient stopped the treatment after 1 dose because of a minor side effect and lack of initial efficacy. Conclusion IVIG may be useful in the treatment of SS‐associated sensorimotor neuropathies or nonataxic sensory neuropathy without any necrotizing vasculitis. The benefit of such therapy in the SS‐related ataxic neuropathy seems less clear.