IVIG Therapy Reduces In-Hospital Mortality and Ventricular Function Loss in Patients with Acute Myocarditis: Meta-Analysis

Noting the efficacy of intravenous immune globulin (IVIG) in the treatment of acute myocarditis remains controversial, Chinese investigators at the Huazhong University of Science and Technology conducted a meta-analysis of published clinical trials that evaluated IVIG therapy in adults and children with acute myocarditis. Searched databases included PubMed, Scopus, Embase, Medline, the Cochrane Library, Google Scholar and the ClinicalTrials.gov website. Pooled odds ratios (ORs) and 95 percent confidence intervals (CIs) were used to estimate the outcomes.

Thirteen studies with 1,534 cases were incorporated into this meta-analysis. Pooled results showed IVIG therapy significantly reduced in-hospital mortality (OR: 0.44, 95% CI 0.17 to 0.71, P< 0.001) and improved left ventricular ejection fraction (OR: 1.73, 95% CI 1.34 to 2.13, P < 0.001) in acute myocarditis patients. Further, patients with acute fulminant myocarditis (AFM) exhibited a significantly higher survival rate (OR: 2.80, 95% CI 1.16 to 6.77, P = 0.022) in the IVIG group.

The investigators concluded “IVIG therapy can not only result in lower in-hospital mortality and superior recovery of left ventricular function in patients with acute myocarditis, but [can] also increase the survival rate of AFM patients. The present study provides some supportive evidence for IVIG therapy in acute myocarditis patients.”