Evidence supporting the use of: Immunoglobulin G
For the health condition: Lupus

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Synopsis

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

Immunoglobulin G (IgG), administered as intravenous immunoglobulin (IVIG), is used as a therapeutic option for systemic lupus erythematosus (SLE, commonly known as lupus), particularly in cases where conventional therapies are ineffective, not tolerated, or contraindicated. The scientific rationale for IVIG in lupus lies in its immunomodulatory effects; IVIG can neutralize autoantibodies, inhibit complement activation, modulate Fc receptor expression on immune cells, and suppress pro-inflammatory cytokines. Several case reports, small open-label studies, and retrospective analyses have documented clinical improvements in lupus manifestations such as thrombocytopenia, nephritis, and neuropsychiatric symptoms following IVIG therapy. However, randomized controlled trials are limited and often include small patient populations, leading to variability in outcomes and a lack of consensus regarding the optimal dosing and long-term efficacy. Major rheumatology guidelines recognize IVIG as a second- or third-line option, primarily for refractory cases or specific complications (e.g., severe cytopenias, infection risk, pregnancy). Thus, while there is scientific evidence supporting the use of IgG/IVIG for lupus, it is considered moderate in strength and largely based on observational studies and clinical experience rather than large-scale, robust trials. Its use is justified in select, difficult-to-treat cases rather than as routine therapy for all lupus patients.

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