Abstract: PO1630
Non-Sucrose Containing IV Immunoglobulin in ANCA Vasculitis Has No Adverse Effects on Renal Function
Session Information
- Glomerular Diseases: Treatment and Outcomes
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1203 Glomerular Diseases: Clinical, Outcomes, and Trials
Authors
- Ysermans, Renee, Maastricht University Medical Center, Department of Internal Medicine, Maastricht, Netherlands
- Busch, Matthias H., Maastricht University Medical Center, Department of Internal Medicine, Maastricht, Netherlands
- Aendekerk, Joop, Maastricht University Medical Center, Department of Internal Medicine, Maastricht, Netherlands
- van Paassen, Pieter, Maastricht University Medical Center, Department of Internal Medicine, Maastricht, Netherlands
Background
Intravenous immunoglobulin (IVIG) has proven to be effective as an immunomodulator in several autoimmune and inflammatory diseases, including antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). Moreover, in the era of B cell-depleting therapies, secondary immunodeficiencies are common, urging suppletion by IVIG. Reported adverse effects are generally mild in nature. However, concerns have been raised about the safety profile of IVIG in relation to renal function. IVIG associated kidney injury is proposed to be mainly related to sucrose stabilized products. Non-sucrose containing alternatives are available and increasingly used. We therefore aimed to analyze the safety of non-sucrose containing IVIG with regard to renal function in patients with AAV.
Methods
AAV patients of the Maastricht University Medical Center were retrospectively analyzed for dynamics of serum creatinine levels before and after IVIG using the Wilcoxon signed rank-test. Subanalyses were performed with regard to the presence of ANCA-associated renal disease and IVIG indication. In addition, correlation analysis was conducted to evaluate the relation between serum creatinine change and cumulative IVIG dose during a 1year follow-up.
Results
36 with 49 courses of IVIG were included in the short-term and 54 patients with 70 courses of IVIG were included in the long-term analysis. No significant differences were found between serum creatinine levels before and after IVIG in the short-term (median [IQR], 132 [88-159] and 125 [86-173] mmol/L, P = 0.380), with a median follow-up of 16 days after the initial IVIG infusion, and the long-term (median [IQR], 104 [86-147] and 110 [90-152] mmol/L, P = 0.077), after 1 year. One patient with active AAV and renal involvement had a reversible serum creatinine increase >30% 6 days after IVIG. Subanalyses showed no significant changes in serum creatinine levels with regard to renal involvement and IVIG indication. There was no association between serum creatinine change and cumulative IVIG dose 1 year after the initial IVIG infusion (P = 0.667).
Conclusion
This study shows no short-term and long-term deleterious effects on renal function in response to treatment with non-sucrose containing IVIG in patients with AAV.