IV immunoglobulin use up in interstitial lung disease

(HealthDay)—Intravenous immunoglobulin (IVIg) is increasingly being used for interstitial lung disease (ILD), despite a lack of evidence for its use, according to research published online Aug. 2 in the Annals of the American Thoracic Society.

Robert W. Hallowell, M.D., from Harvard Medical School in Boston, and colleagues explored use of IVIg and examined its role as potential adjunct therapy for ILD.

The researchers note that IVIg use has expanded in recent decades to include treatment of autoimmune and inflammatory disorders. IVIg has an immunomodulatory effect, acting via neutralization of pathogenic autoantibodies, alteration of immune cell effector function, suppression of cytokine and chemokine activity, and interference with activation of complement. IVIg is increasingly being used for treatment of ILD, which is a frequent complication of autoimmune disorders and connective tissue disease. No large studies are currently available to support the use of IVIg in ILD, but it is being used off-label for refractory cases that have failed to respond to standard immunosuppression. IVIg is more costly than traditional agents but is associated with less systemic toxicity and global immunosuppression.

"While IVIg is relatively well tolerated, it is much more expensive than traditional therapies, and there is currently not adequate data to support its routine use in this context," the authors write. "As such, clinical trials are necessary to determine if IVIg has a role in the treatment of ILD."

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