[Use of intravenous immunoglobulins for immunomodulating therapy of inflammatory rheumatic diseases]

The use of immunosuppressive and long-acting antirheumatic drugs in the treatment of rheumatic diseases is often limited by their side effects. Therefore, it is urgent to search for drugs which are better tolerated and which are at least as effective. Several studies have been performed using intravenously administered immunoglobulins in rheumatoid arthritis patients and in small groups of patients suffering from other connective tissue diseases. The results demonstrate a rapid onset of clinical improvement in patients who respond to this treatment. The tolerance has been excellent so far. This therapy is immunomodulating, since it induces changes in B- and T-lymphocyte function, especially in immunoregulatory T-cell subpopulations. Future work should focus on the establishment of treatment schedules and on the definition of patient subgroups which might benefit most from intravenous immunoglobulin therapy.