Abstract | BACKGROUND: OBJECTIVES: To evaluate prospectively the efficacy of IVIg for PV using an 'n-of-1' placebo-controlled trial. METHODS: A randomized, placebo-controlled, crossover trial of IVIg was conducted in a single patient with severe PV, comprising two phases of six consecutive months of either IVIg or placebo infusion. Before the commencement of the trial, the patient had received 18 months of IVIg but concerns about the continuing therapeutic efficacy of IVIg led to the double-blind placebo-controlled 'n-of-1' trial of IVIg. RESULTS:
Pemphigus autoantibody titres were significantly higher when on placebo compared with IVIg treatment (median 1 : 80 vs. 1 : 20, P = 0.007), desmoglein 3 (126 vs. 79, P = 0.004) and desmoglein 1 antibody levels (126 vs. 94, P = 0.004). There was a significant improvement in subjective disease activity scores while on IVIg compared with placebo (mean overall score 11.6 vs. 20.6, P < 0.0001). CONCLUSIONS: The results of this study confirm a beneficial effect of IVIg in the management of refractory PV.
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Authors | D F Arnold, J Burton, B Shine, F Wojnarowska, S A Misbah |
Journal | The British journal of dermatology
(Br J Dermatol)
Vol. 160
Issue 5
Pg. 1098-102
(May 2009)
ISSN: 1365-2133 [Electronic] England |
PMID | 19222460
(Publication Type: Case Reports, Journal Article, Randomized Controlled Trial)
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Chemical References |
- Autoantibodies
- Immunoglobulin G
- Immunoglobulins, Intravenous
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Topics |
- Adult
- Autoantibodies
(immunology)
- Cross-Over Studies
- Double-Blind Method
- Drug Administration Schedule
- Humans
- Immunoglobulin G
(therapeutic use)
- Immunoglobulins, Intravenous
(therapeutic use)
- Male
- Pemphigus
(drug therapy, immunology)
- Severity of Illness Index
- Treatment Outcome
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