Mar. 19, 1999 DENVER-People with severe asthma who are "insensitive" to steroids need less of the medication, fewer "bursts" of it in emergencies and spend less time in the hospital when using intravenous immunoglobulin (IVIG) in conjunction with steroids, according to research published today in the Journal of Allergy and Clinical Immunology.
Researchers found that during the 6-month study, patients had fewer hospitalizations for asthma attacks than in the 6 months prior to the study, even though they used less glucocorticoids, known generally as steroids.
IVIG also was as effective in people whose asthma can be treated with glucocorticoids, as it was in people whose asthma usually doesn't respond to glucocorticoids, or who are "steroid-insensitive." Researchers believe IVIG increases steroid sensitivity of the lungs to steroids, in part, by reducing lung inflammation. "We saw patients whose asthma does very poorly and who needed high doses of steroids to control the disease," said Erwin Gelfand, M.D., a pediatric immunology and asthma specialist and chair of the Department of Pediatrics at National Jewish Medical and Research Center.
While steroid-insensitive patients must take higher doses to achieve minimal control of their disease, they also may become dependent on the medication to breathe normally. Researchers found that by taking IVIG in conjunction with glucocorticoids, patients could use less glucocorticoids more efficiently.
Long-term use of glucocorticoids can stunt growth in children or cause osteoporosis, while IVIG has few side effects. "Compared to steroids, IVIG is not toxic at all," Dr. Gelfand said. "In addition, lowering the amount of steroids a patient takes reduces side effects and the patient's quality of life improves dramatically."
IVIG treatments cost several thousand dollars each month for people with severe asthma, but many health insurance companies cover the cost because, as this study shows, IVIG lowers emergency room and hospital use by patients with severe asthma. Glucocorticoids reduce inflammation in the lungs. IVIG is an antibody that is removed from the plasma portion of blood and is concentrated for use as a medication. IVIG can regulate the immune/inflammatory system and has been shown to reduce inflammation in the lungs.
National Jewish Medical and Research Center is ranked as the best hospital in the United States for respiratory diseases by U.S. News & World Report, 1998-1999.
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