Le indicazioni al trattamento con immunoglobuline endovena nella sindrome da anticorpi antifosfolipidi. [Indications for intra-venous immunoglobulins treatment in the antiphospholipid syndrome]

The use of intravenous immunoglobulins (IVIg) remains controversial after their introduction in therapeutics during the 80s. Their mechanism of action remains unexplained for certain pathologies, but their application to new indications and their economical impact makes them a target of many studies and protocols of use. Their immunomodulating effect is the basis of their use on a great variety of autoimmune diseases and inflammatory processes. In other autoimmune conditions (i.e., systemic lupus erythematosus, anti-phospholipid syndrome, ecc), it is still empirical although very efficacious and many papers dealing with IVIg therapy in APS are reported in literature. Efforts are taken in order to minimise these adverse effects both by pharmaceutical companies that attempt to decrease the risk of infectious agents transmission, and by physicians who monitor closely patients and choose the appropriate mode of administration of IVIg with respect to dose, duration of treatment and preparations used. Overall, IVIg is used in severe medical conditions and it is quite safe. Future research would help to further minimise its associated risks.