INTRAVENOUS immunoglobulin showed favorable outcomes and was generally well tolerated across severe dermatologic diseases over 20 years.
The real-world cohort study included 285 patients who received intravenous immunoglobulin (IVIG) at a tertiary dermatology center between January 2001 and November 2021. Researchers assessed patient demographics, diagnoses, comorbidities, treatment responses, and immediate and delayed adverse events.
Autoimmune bullous diseases accounted for 61% of the conditions treated, making them the largest diagnostic group in the cohort. Favorable clinical outcomes were recorded across disease categories, with particularly positive results among patients with autoimmune bullous diseases and those on the Stevens–Johnson syndrome/toxic epidermal necrolysis spectrum.
These findings provide long-term clinical insight into the use of intravenous immunoglobulin in dermatologic diseases that are severe, immune mediated, or refractory to treatment. They also support its continued use in routine dermatology practice when treatment decisions are guided by individual patient characteristics.
Adverse events occurred in 44 patients, representing 15.4% of the cohort. Both immediate and delayed reactions were documented during the study period.
Hypertension and flu-like symptoms were the most common immediate reactions. The most clinically significant delayed complications were renal impairment and thromboembolic events. Adverse events were not associated with the underlying dermatologic diagnosis, suggesting that the disease being treated did not independently determine treatment tolerability.
However, adverse events were significantly more common among patients with comorbidities. This association highlights the importance of reviewing coexisting conditions before initiating IVIG and considering how they may affect treatment safety.
The findings suggest that intravenous immunoglobulin can offer favorable outcomes across diverse dermatologic diseases while maintaining an acceptable overall safety profile. Nevertheless, the occurrence of renal and thromboembolic complications reinforces the need for careful patient selection and monitoring.
Assessment of comorbidities before treatment may help clinicians identify patients who require closer observation. Individualized infusion strategies may also help minimize treatment-related adverse events while allowing patients with severe dermatologic disease to receive IVIG when clinically appropriate.
Reference
Aydogan K et al. Adverse Events and Real-World Outcomes of Intravenous Immunoglobulin in Dermatologic Diseases: A 20-Year Cohort Study. Clin Exp Dermatol. 2026;doi:10.1093/ced/llag410.
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