Evidence supporting the use of: Immunoglobulin
For the health condition: Influenza

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Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Immunoglobulin (specifically, intravenous immunoglobulin or IVIG) has been explored as a supportive treatment for severe influenza, particularly in immunocompromised patients or those with severe complications. The rationale is that immunoglobulins can provide passive immunity by supplying antibodies that may neutralize influenza viruses. Historical use dates back to the pre-antiviral era, when convalescent plasma or serum was sometimes administered during severe outbreaks, with some anecdotal benefit. However, modern evidence is limited and mixed. A few small clinical studies and case reports have suggested that IVIG, especially preparations enriched with anti-influenza antibodies, could potentially reduce viral load or improve outcomes in severe or complicated influenza. However, large randomized controlled trials are lacking. Systematic reviews and guidelines (such as those from the Infectious Diseases Society of America) generally do not recommend routine use of IVIG for influenza except in research settings or selected immunodeficient patients. The 2018 IDSA guidelines state that there is insufficient evidence to recommend for or against adjunctive immunoglobulin therapy in severe cases. In summary, while there is a scientific rationale and some limited supportive data for IVIG use in severe or refractory influenza, clear clinical benefits have not been robustly demonstrated, and the evidence base remains weak (hence the rating of 2/5).

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