The following is a summary of “Role of Intravenous Immunoglobulins in Systemic Sclerosis (SSc): A Systematic Literature Review,” published in the June 2024 issue of Rheumatology by Koczanowski et al.

Systemic sclerosis (SSc) is a heterogeneous, multi-system autoimmune disease characterized by progressive fibrosis of the skin and internal organs, leading to significant morbidity and mortality. Intravenous Immunoglobulin (IVIG) has emerged as a therapeutic option for SSc, but its efficacy across various organ manifestations has shown variability, and a comprehensive review of its use needs to be improved. This study aims to systematically evaluate the existing literature on the role of IVIG in managing different manifestations of SSc.

Medline, Embase, Cochrane, Web of Science, and Scopus databases were searched from January 1, 2003, to April 15, 2024, using keywords related to SSc and IVIG. The inclusion criteria were English-language full-text studies involving at least five adult patients diagnosed with SSc treated using IVIG, reporting any measurable outcome. Of the 418 potentially relevant records, 12 studies met the inclusion criteria, involving 266 patients. The selected studies included one randomized controlled trial, two pilot studies, one open-label study, seven retrospective studies, and one case-control study. The outcomes assessed spanned five organ systems: cutaneous, respiratory, musculoskeletal, gastrointestinal, and other clinical benefits such as overall improvement and corticosteroid-sparing.

The results indicated that IVIG had a favorable impact on reducing skin thickening, alleviating muscle and joint pain, improving gastrointestinal symptoms, lowering steroid doses, and enhancing patient and physician-reported quality of life. Although the benefits of IVIG for respiratory manifestations were less pronounced, stabilization in pulmonary function tests and radiological features was observed, which can be considered a positive outcome. However, the analysis was limited by the lack of high-quality studies and the frequent use of concomitant therapies, which made it challenging to isolate the efficacy of IVIG alone.

In conclusion, IVIG appears beneficial for certain manifestations of SSc, though the evidence is less convincing for others. The study underscores the need for well-designed clinical trials to better understand the efficacy of IVIG and to develop informed guidelines for its use in treating SSc. Further research should focus on high-quality trials to confirm these preliminary findings and to refine treatment protocols for improving patient outcomes in SSc.

Source: sciencedirect.com/science/article/pii/S0049017224001112