Intravenous immunoglobulin G therapy in streptococcal toxic shock syndrome:: A European randomized, double-blind, placebo-controlled trial

被引:322
作者
Darenberg, J
Ihendyane, N
Sjölin, J
Aufwerber, E
Haidl, S
Follin, P
Andersson, J
Norrby-Teglund, A
机构
[1] Huddinge Univ Hosp, Karolinska Inst, Dept Med, Ctr Infect Med, S-14186 Huddinge, Sweden
[2] Karolinska Hosp, Dept Infect Dis, Div Med, S-10401 Stockholm, Sweden
[3] Univ Uppsala Hosp, Dept Med Sci, Uppsala, Sweden
[4] Malmo Univ Hosp, Dept Infect Dis, Malmo, Sweden
[5] Linkoping Univ Hosp, Dept Infect Dis, S-58185 Linkoping, Sweden
关键词
D O I
10.1086/376630
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
The efficacy and safety of high-dose intravenous polyspecific immunoglobulin G (IVIG) as adjunctive therapy in streptococcal toxic shock syndrome (STSS) were evaluated in a multicenter, randomized, double-blind, placebo-controlled trial. The trial was prematurely terminated because of slow patient recruitment, and results were obtained from 21 enrolled patients (10 IVIG recipients and 11 placebo recipients). The primary end point was mortality at 28 days, and a 3.6-fold higher mortality rate was found in the placebo group. A significant decrease in the sepsis-related organ failure assessment score at days 2 (P = .02) and 3 (P = .04) was noted in the IVIG group. Furthermore, a significant increase in plasma neutralizing activity against superantigens expressed by autologous isolates was noted in the IVIG group after treatment (P = .03). Although statistical significance was not reached in the primary end point, the trial provides further support for IVIG as an efficacious adjunctive therapy in STSS.
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收藏
页码:333 / 340
页数:8
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