Intravenous immunoglobulins in hospitalized patients with idiopathic inflammatory myopathy

Autores: Gustavo Ariel Medina, Carla Muñoz Torres, Rossio Gardenia Ortuño Lobo, Ignacio López

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Introduction:
Intravenous immunoglobulin (IVIG) has been primarily used in refractory or severe cases of idiopathic inflammatory myopathies (IIM).

Objectives:
To describe the prevalence of IVIG use and associated variables during hospitalization in patients with IIM.

Materials and methods:
We conducted a retrospective study of patients hospitalized with IIM between 2015 and 2023. Variables associated with IVIG therapy were analyzed.

Results:
The study included 46 IIM-related hospitalizations (mean age 50.8 years, female predominance). Dermatomyositis was the most common phenotype (76.1%). Twenty-four patients (52%) received IVIG treatment. The IVIG group showed: higher dysphagia prevalence (83.3% vs 36.4%; p<0.001), mainly moderate (29.2% vs 9.1%) and severe cases (33.3% vs 0%; p<0.001); greater autoantibody positivity (70.8% vs 36.4%; p=0.04); and more frequent hospitalizations due to disease relapse (54.2% vs 22.7%; p=0.03). Although median creatine kinase levels were higher in the IVIG group (2030 mg/dL; IQR: 150–6955), no significant difference was found compared to controls (p=0.18). IVIG was well tolerated with no reported adverse events.

Conclusions:
Dysphagia and IIM relapse were the main clinical variables associated with IVIG indication.