How do you recommend tapering IVIG in patients whose inflammatory myositis has achieved remission?
This is a very good question without any right or wrong answer. My practice is to start tapering the IVIG 6 months after the patient has achieved clinical remission. I usually start decreasing the dose of the IVIG, but the other option is to extend the interval between the patient's infusions. The e...
This is a challenging question since each provider does it differently, similarly akin to steroid tapers. There are several options including spacing out the frequency of IVIG from every 4 weeks to every 6 weeks, then every 8 weeks, then every 12 weeks, then stop; or you can also lower the dose firs...
I have discontinued it after the patient gets his muscle strength back and started them on MTX or Azathioprine and they have done well.
I have seen too many patients do poorly on reduced dose IVIG. I do not recommend reducing dose, but rather I space the frequency. If patients are stable receiving IVIG at q3-4 months after a couple of cycles, I try to discontinue that part of the multiagent therapy. Many patients simply cannot be sp...