IVIG is indicated in patients with IIM as adjunctive therapy to corticosteroids and/or a steroid sparing agent in patients with IIM who have failed 1st line therapy or as clinically indicated in the management of severe disease.
*IVIG benefit has not been established in IBM.
1st line: Corticosteroids and Methotrexate and/or Azathioprine
2nd line: IVIG
3rd line: Cyclosporine or cellcept
Maximum dose is 2 g/kg to be given over 2 days initially monthly for 3-6 months and if effective to be continued at decreasing frequency (determine minimum effective dose) over approximately 2 years.
Survival of patients with IIM has been shown to be substantially improved in patients given IVIG.