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Abstract Number: 1558

Intravenous Immunoglobulin Efficacy for Primary Sjögren’s Syndrome Associated Small Fiber Neuropathy

Antoine Gaillet1, Karine Champion1, Jean-Pascal Lefaucheur2, Herve Trout3, Jean-François Bergmann1 and Damien Sène4, 1Internal Medicine Department, Lariboisière Hospital, Paris, France, 2Clinical Neurophysiology Unit,, Henri-Mondor Hospital, Créteil, France, 3Pharmacy Department, Lariboisière Hospital, Paris, France, 4Lariboisière Hospital, Paris Diderot University, Paris, France

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: Intravenous immunoglobulin (IVIG), pain, quality of life and small fiber neuropathy, Sjogren's syndrome

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Session Information

Date: Monday, October 22, 2018

Title: Sjögren's Syndrome – Basic and Clinical Science Poster

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: To analyze the efficacy and tolerance of intravenous immunoglobulin (IVIG) therapy in 11 patients with primary Sjögren’s syndrome (pSS)-associated small-fiber neuropathy (SFN).

Methods: Retrospective, single-center study of the efficacy and safety of IVIG therapy for 6 months (0.4 g/kg/day monthly for 5 days) in 11 consecutive pSS-SFN patients. The primary endpoint was a decrease in pain intensity (scored on a 0-10 Numeric Rating Scale, NRS) ≥ 30% between the onset (M0) and the end of treatment (M6). The impact of treatment on quality of life (SF-36 scale) and small fiber neurophysiological tests was also evaluated.

Results: The median (95%CI) age at treatment onset was 52 (48-63) years with a median duration of SFN symptoms until treatment of 6.5 (3-11) years. Between M0 and M6, the median NRS score decreased from 7 (5.5-8) to 3 (1.8-5) (P <0.00001). The primary endpoint was achieved in 8 patients (72%). The median SF-36 physical component subscore also significantly improved from 23/100 to 48/100 (P = 0.003). Regarding neurophysiological tests, only the warm detection threshold improved from 5.5°C to 4.6°C (P = 0.01), others remaining stable. The most common side effect was transient headache during infusion (73%), while no major side effect was reported.

Conclusion: IVIG treatment appears to be effective and well tolerated in pSS-associated SFN, leading to a significant pain relief and improvement of quality of life and thermal sensory testing. These encouraging results need to be interpreted with caution and have to be confirmed in a randomized double-blinded placebo-controlled trial.


Disclosure: A. Gaillet, None; K. Champion, None; J. P. Lefaucheur, None; H. Trout, None; J. F. Bergmann, None; D. Sène, None.

To cite this abstract in AMA style:

Gaillet A, Champion K, Lefaucheur JP, Trout H, Bergmann JF, Sène D. Intravenous Immunoglobulin Efficacy for Primary Sjögren’s Syndrome Associated Small Fiber Neuropathy [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/intravenous-immunoglobulin-efficacy-for-primary-sjogrens-syndrome-associated-small-fiber-neuropathy/. Accessed .
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