Recent Research Relating to Cicatricial Pemphigoid and the Use of Intravenous Immunoglobulin (IVIG)

C. Stephen Foster, MD, FACS, FACR

Dr. Foster et al. recently published a chart review of all Ocular Cicatricial Pemphigoid (OCP) patients seen at the Massachusetts Eye Research and Surgery Institution (MERSI) between 2005 and 2015 to look at the management of OCP with Intravenous Immunoglobulin (IVIG) as the only therapy. IVIG infusion was administered in the usual manner with the dose being two grams per KG of weight and the total dose divided for infusion over three consecutive days every month.

Five hundred and twelve (512) patients were identified with OCP at MERSI, and only17 patients or 34 eyes were treated with IVIG as the only therapy.  Seven were female, and ten were male with the average age at diagnosis as 60.7 years old.  The follow-up time ranged from 12 to 140 months. Twenty-six eyes (76.5%) achieved remission. Nine remission eyes received cataract surgeries, and 2 of them had a relapse (22.2%). The other 17 eyes did not undergo ocular surgery and remained in remission.

The findings revealed that IVIG as only therapy showed high efficacy in stage one on Foster staging scale of OCP (7/7, 100%).  Ocular surgery can be associated with OCP relapse.  The conclusion from the chart review study was IVIG monotherapy is an effective and safe therapy in patients with stubborn OCP.  However, ocular surgery can be associated with OCP relapse even when a patient was in remission.  Rituxan and IVIG combination are still top of the line treatment for OCP.

#ocularcicatricialpemphigoid #ocp #intravenousimmunoglobulin #IVIG