Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Immunoglobulin G (IgG), typically administered as intravenous immunoglobulin (IVIG), has a scientific basis for use in the treatment of systemic lupus erythematosus (SLE), particularly in specific scenarios. IVIG is a preparation of pooled IgG antibodies from healthy donors and is used as an immunomodulatory therapy. Although not considered first-line treatment for lupus, IVIG is often reserved for patients who are refractory to standard therapies (such as corticosteroids or immunosuppressants) or for those with contraindications to these medications.

The scientific rationale behind IVIG’s use in lupus is its ability to modulate the immune system. IVIG is thought to reduce the production of pathogenic autoantibodies, inhibit complement activation, and modulate the function of Fc receptors on immune cells. These actions can help dampen the autoimmune response characteristic of SLE. Clinical studies and case reports have shown that IVIG can be effective in treating lupus manifestations such as severe thrombocytopenia, neuropsychiatric lupus, and lupus nephritis when conventional treatments fail or are not tolerated.

However, the evidence supporting the routine use of IVIG in lupus is moderate (rated 3/5). The majority of data comes from small clinical trials, observational studies, and case series rather than large, randomized controlled trials. As such, major rheumatology guidelines recommend its use only in select, refractory cases. IVIG is generally well-tolerated, but its high cost and potential side effects (such as headache, thromboembolic events, and renal dysfunction) limit its widespread use.

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