Treatment with IgM-enriched immunoglobulin in sepsis: a matched case-control analysis

The therapeutic potential of IgM-enriched immunoglobulin preparations (IgGAM) in sepsis remains a field of debate. The use of polyclonal immunoglobulins as adjuvant therapy (Esen & Tugrul, 2009; Kaukonen et al., 2014; Molnár et al., 2013; Taccone et al., 2009) has been shown to improve clinical...

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Autores:
Martinez, Jorge Ignacio
Sánchez, Hector Fabio
Velandia, Julio Alberto
Urbina, Zulma
Florián, María Cristina
Martínez, Mauricio Antonio
Giamarellos Bourboulis, Evangelos J.
Pino Pinzón, Carmen Juliana
Ortiz, Guillermo
Celis, Edgar
Tipo de recurso:
Article of journal
Fecha de publicación:
2021
Institución:
Universidad El Bosque
Repositorio:
Repositorio U. El Bosque
Idioma:
eng
OAI Identifier:
oai:repositorio.unbosque.edu.co:20.500.12495/5889
Acceso en línea:
http://hdl.handle.net/20.500.12495/5889
https://doi.org/10.1016/J.JCRC.2021.03.015
Palabra clave:
Sepsis
Septic shock
IgM-enriched immunoglobulins
Rights
openAccess
License
Acceso abierto
Description
Summary:The therapeutic potential of IgM-enriched immunoglobulin preparations (IgGAM) in sepsis remains a field of debate. The use of polyclonal immunoglobulins as adjuvant therapy (Esen & Tugrul, 2009; Kaukonen et al., 2014; Molnár et al., 2013; Taccone et al., 2009) has been shown to improve clinical outcomes in terms of mortality. This study analyze the impact of IgM-enriched IgG (IgGM) as additional immunomodulation. Patients and methods: This is a retrospective registry of 1196 patientswith severe sepsis and septic shock fromnine Intensive Care Units in Colombia, from routine clinical practice; 220 patients treated with IgGAM were registered. Fully matched comparators for severity and type of infection selected among patients non-treated with IgGAM. Mortality after 28 days was 30.5% among IgGAM-treated patients and 40.5% among matched comparators. Results: Multivariate Cox regression analysis showed IgGAM treatment to be the only variable protective from death after 28 days (hazard ratio 0.62; 0.45–0.86; p: 0.004). Results reinforce the importance of IgGAM treatment for favorable outcome after septic shock and are in line with recent published meta-analyses. This study showed that treatment with IgGM in patients with sepsis was an independent modulator of the 28-day associated witha lower mortality.