Single-Dose IVIG Results in Early Improvements in Sepsis Patients

A recent study conducted in Japan showed significant early post-administration improvements in sepsis patients who were given a single-dose administration of intravenous immune globulin (IVIG). The study analyzed 79 patients admitted to the intensive care unit (ICU) of tertiary care institutions due to severe sepsis or septic shock. Patients were randomly divided into a group that was administered standard divided doses of IVIG (5 g/day for three days, S group) or a group that was administered a standard single dose of IVIG (15 g/day for one day, H group). Freeze-dried sulfonated human IVIG was used. The longitudinal assessment of procalcitonin (PCT) levels, C-reactive protein (CRP) levels, white blood cell count, blood lactate levels, IL-6 levels, sequential organ failure assessment (SOFA) score and systemic inflammatory response syndrome (SIRS) was conducted, as well as mechanical ventilation duration (days), ICU stay (days), and 28-day and 90-day survival rates.

While the study showed no significant differences in PCT levels, CRP levels, and 28-day and 90-day survival rates between the two groups, patients in group H showed improvements in the various SIRS diagnostic criteria, IL-6 levels and blood lactate levels in the early stages after IVIG administration. In light of the non-recommendation of IVIG therapy in the Surviving Sepsis Campaign Guidelines 2012, the researchers say the findings of significant early post-administration improvements are noteworthy because IVIG’s anti-inflammatory effects may account for the early reduction in IL-6 levels after treatment, and the accompanying improvements in microcirculation may improve blood lactate levels and reduce SOFA scores. However, they said the low dosages of IVIG in Japan may limit the anti-cytokine effects of this treatment, and, therefore, further studies are needed to determine appropriate treatment regimens of single-dose IVIG.