| Sumario: | The objective of this report was to summarise clinically relevant effects of immunomodulatory treatments with intravenous immunoglobulins (IVIG). We searched systematically for systematic reviews evaluating the effectiveness of IVIG for autoimmune diseases and other conditions causing harmful immunological and inflammatory reactions. The searches were performed in the international databases Cochrane Library and Centre for Review and Dissemination Database. We were interested in systematic reviews that compared IVIG with other interventions, no intervention or placebo. Two reviewers assessed inclusion criteria and methodological quality independently. We also rated our confidence in the effect estimates. The literature search identified 254 unique references. Of these, 11 systematic reviews met our inclusion criteria. All the included reviews had high methodological quality. They focused on the following indications for IVIG: dermatomyositis/polymyositis, carditis in rheumatic fever, myasthenia gravis, haemolytic disease in neonates, multiple sclerosis, Guillain-Barre syndrome (GBS), Kawasaki disease in children, acute myocarditis, sepsis, chronic inflammatory demyelinating polyneuropathy (CIDP) and multifocal motor neuropathy. Well documented effects of immunomodulatory treatments with IVIG were reduced risk of coronary artery abnormalities the first 30 days after treatment of children with Kawasaki disease, and improvements in disability in CIDP patients. It was also well documented that IVIG and plasma exchange have equivalent effectiveness for GBS. There is a need for further research on several of the included indications for IVIG. Further, many of the included systematic reviews need to be updated. It would also be of interest to summarise randomised controlled trials of the effectiveness of IVIG for idiopathic thrombocytopenic purpura (ITP), for which IVIG is a commonly used intervention.
|
|---|
