{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T16:12:06Z","timestamp":1791216726829,"version":"4.1.0"},"reference-count":18,"publisher":"The Journal of Rheumatology","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Rheumatol"],"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective.<\/jats:title>\n                    <jats:p>We sought to retrospectively review a single-center experience using intravenous immunoglobulin (IVIG) for the treatment of refractory, active diffuse cutaneous systemic sclerosis (dcSSc).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods.<\/jats:title>\n                    <jats:p>The mean modified Rodnan Skin score (mRSS) at baseline was compared to the mRSS at 6, 12, 18, and 24 months post-IVIG initiation by the paired Student t test. Changes in mRSS at 6 and 12 months were also compared to data from historical controls of 3 large, negative, multicenter, randomized clinical trials of other medications [D-penicillamine (D-pen), recombinant human relaxin (relaxin), and oral bovine type I collagen (collagen)] and to patients treated with mycophenolate mofetil (MMF) alone using the Student t test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results.<\/jats:title>\n                    <jats:p>Thirty patients were treated with adjunctive IVIG (2 g\/kg\/mo) for refractory, active dcSSc. The mean baseline mRSS of our cohort was 29.6 \u00b1 7.2, and this significantly decreased to 24.1 \u00b1 9.6 (n = 29, p = 0.0011) at 6 months, 22.5 \u00b1 10.0 (n = 25, p = 0.0001) at 12 months, 20.6 \u00b1 11.8 (n = 23, p = 0.0001) at 18 months, and 15.3 \u00b1 6.4 (n = 15, p &lt; 0.0001) at 24 months. The mean change in mRSS at 6 months was not significantly different in the IVIG group (\u22125.3 \u00b1 7.9) compared to the relaxin trial (\u22124.8 \u00b1 6.99, p = 0.74) or MMF group (\u22123.4 \u00b1 7.4, p = 0.26); however, at 12 months, the mean change in mRSS was significantly better in the IVIG group (\u22128 \u00b1 8.3) than in the D-pen (\u22122.47 \u00b1 8.6, p = 0.005) and collagen (\u22123.4 \u00b1 7.12, p = 0.005) groups, and was comparable to the group of primary MMF responders (\u22127.1 \u00b1 9, p = 0.67).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion.<\/jats:title>\n                    <jats:p>Our observational study suggests that IVIG may be an effective adjunctive therapy for active dcSSc in patients failing other therapies.<\/jats:p>\n                  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