[Treatment of rheumatoid polyarthritis with IgG eluted from the placenta. Results of an open study on 31 patients]

Thirty-one patients presenting classical or defined, severe and active rheumatoid polyarthritis (RP) unresolved by most of the usual basic treatments (due to inefficacy or safety problems) were treated with human placental IgG preparations (HPIgG) in an open study. Various therapeutic protocols were tested to determine the most efficacious dosage. Favorable results were noted in 62% of cases. Improvement was generally rapid, often occurring after the first week of treatment. Rheumatoid nodules subsided by more than 50% and were resolved in two of nine cases. A decrease in dosage of analgesics or anti-inflammatories was possible in seven of 31 cases. Remission of RP of duration exceeding six months after withdrawal of HPIgG treatment was noted in six of 18 favorable results (33.3%). Best results were seen with intravenous administration of 1,500 mg per day seven days per month. No clinical or immunological effects were seen in a control group treated with venous globulins (1,500 mg/day for seven days). Safety was very satisfactory: four withdrawals from treatment due to proteinuria (3 cases) or phlebitis (1 case); these adverse reactions subsided rapidly. Immunostimulation of lymphocyte function was seen in all patients treated with HPIgG. The mode of action of HPIgG is currently under study. HPIgG may act as polyspecific antibodies against class II HLA antigens thus opening up the possibility of a new type of therapeutic immunomodulation in man.