Trial of intravenous immunoglobulin in dermatomyositis: a critically appraised research paper

Aggarwal et al. recently reported results from the first successful phase III trial studying intravenous immunoglobulin (IVIG) in dermatomyositis (DM). The study showed that improvement in disease activity was clinically and statistically significantly greater in those who received IVIG than in those who received placebo, allowing US Food and Drug Administration approval for use of IVIG in DM. Despite its success, this study also highlights several concerns that must be addressed to inform future trials in the field, particularly the inclusion of patients with skin-predominant/amyopathic and post-myopathic DM.