{"id":27928,"date":"2025-12-02T16:58:55","date_gmt":"2025-12-02T23:58:55","guid":{"rendered":"https:\/\/ameripharmaspecialty.com\/?p=27928"},"modified":"2025-12-02T16:59:01","modified_gmt":"2025-12-02T23:59:01","slug":"when-to-consider-ivig-for-macrophage-activation-syndrome-mas-key-insights-based-on-the-latest-evidence","status":"publish","type":"post","link":"https:\/\/ameripharmaspecialty.com\/es\/ivig\/when-to-consider-ivig-for-macrophage-activation-syndrome-mas-key-insights-based-on-the-latest-evidence\/","title":{"rendered":"Cu\u00e1ndo considerar la IgIV para el s\u00edndrome de activaci\u00f3n macrof\u00e1gica (SAM): informaci\u00f3n clave basada en la evidencia m\u00e1s reciente"},"content":{"rendered":"\n<p><a href=\"https:\/\/ameripharmaspecialty.com\/ivig\/ivig\/\">Intravenous immunoglobulin<\/a> (IVIG) for macrophage activation syndrome (MAS) may be an option when patients cannot use other immunosuppressive medications. Discover how IVIG works, learn about its potential benefits, and find answers to your most common questions.<\/p>\n\n\n\n<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_82_2 counter-hierarchy ez-toc-counter ez-toc-custom ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/ameripharmaspecialty.com\/es\/ivig\/when-to-consider-ivig-for-macrophage-activation-syndrome-mas-key-insights-based-on-the-latest-evidence\/#Highlights\" >Highlights<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/ameripharmaspecialty.com\/es\/ivig\/when-to-consider-ivig-for-macrophage-activation-syndrome-mas-key-insights-based-on-the-latest-evidence\/#A_Quick_Overview_of_Macrophage_Activation_Syndrome_MAS\" >A Quick Overview of Macrophage Activation Syndrome (MAS)<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/ameripharmaspecialty.com\/es\/ivig\/when-to-consider-ivig-for-macrophage-activation-syndrome-mas-key-insights-based-on-the-latest-evidence\/#Treatment_of_Macrophage_Activation_Syndrome\" >Treatment of Macrophage Activation Syndrome&nbsp;<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/ameripharmaspecialty.com\/es\/ivig\/when-to-consider-ivig-for-macrophage-activation-syndrome-mas-key-insights-based-on-the-latest-evidence\/#IVIG_for_Macrophage_Activation_Syndrome_What_We_Know_So_Far\" >IVIG for Macrophage Activation Syndrome: What We Know So Far<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/ameripharmaspecialty.com\/es\/ivig\/when-to-consider-ivig-for-macrophage-activation-syndrome-mas-key-insights-based-on-the-latest-evidence\/#IVIG_for_Macrophage_Activation_Syndrome_Understanding_the_Mechanism_of_Action\" >IVIG for Macrophage Activation Syndrome: Understanding the Mechanism of Action<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/ameripharmaspecialty.com\/es\/ivig\/when-to-consider-ivig-for-macrophage-activation-syndrome-mas-key-insights-based-on-the-latest-evidence\/#Frequently_Asked_Questions\" >Frequently Asked Questions<\/a><\/li><\/ul><\/nav><\/div>\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Highlights\"><\/span>Highlights<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Macrophage activation syndrome (MAS) is a rare but potentially life-threatening immune response.\u00a0<\/li>\n\n\n\n<li>IVIG for macrophage activation syndrome may serve as a first- or second-line treatment, depending on the underlying trigger, the patient\u2019s response to other medications, and the stage of macrophage activation.\u00a0<\/li>\n\n\n\n<li>IVIG is usually preferred when a patient is moderately ill and has an underlying infection.\u00a0<\/li>\n\n\n\n<li>How IVIG works for MAS is unclear. However, it is thought to work by suppressing macrophage activation and promoting the release of anti-inflammatory molecules.\u00a0<\/li>\n\n\n\n<li>Large, controlled trials are needed to confirm clear benefits and dosage ranges.\u00a0<\/li>\n<\/ul>\n\n\n\n<div  id=\"call-to-action-02939f2975ba4c400af5107354d78ded\" style=\"\" class=\"ct_call_to_action\">\n\t<div class=\"container\">\n\t\t<div class=\"block-wrap cta\">\n\t\t\t<div class=\"block-column\">\n\t\t\t\t<div class=\"cta_headings\">\n\t\t\t\t\t\t\t\t\t\t\t<h4 class=\"cta__heading\">\n\t\t\t\t\t\t\tSpeak to a Specialist\t\t\t\t\t\t<\/h4>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"cta__sub__heading\">\n\t\t\t\t\t\t\tAbout Copay Assistance\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<span class=\"cta_btn\">\n\t\t\t\t\t\t<a href=\"tel:8777780318\">(877) 778-0318<\/a>\n\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"A_Quick_Overview_of_Macrophage_Activation_Syndrome_MAS\"><\/span>A Quick Overview of Macrophage Activation Syndrome (MAS)<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>MAS is a rare but potentially fatal immune response to rheumatic disorders, cancers, infections, or medications. It occurs when your immune system floods the body with certain types of white blood cells called macrophages and T cells.&nbsp;<\/p>\n\n\n\n<p>Normally, these cells help destroy disease-causing microorganisms and cancer cells. However, in MAS, these white blood cells become ineffective. As a result, the immune system produces more of these cells, potentially leading to failure of organ systems or death.&nbsp;<\/p>\n\n\n\n<p>Studies show death may occur in 20% to 53% of cases [<a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC8243343\/\">1<\/a>].<\/p>\n\n\n\n<p>What causes the immune system to overreact is not fully understood, and many cases occur without any identifiable triggers. Infections are thought to trigger nearly 50% of MAS cases. Additionally, 10% of children with systemic juvenile idiopathic arthritis develop full-blown MAS [<a href=\"https:\/\/jpedres.org\/articles\/macrophage-activation-syndrome-in-children-with-systemic-juvenile-idiopathic-arthritis-successfully-treated-with-megadose-methyl-prednisolone-therapy\/jpr.30602\">2<\/a>].<\/p>\n\n\n\n<p>Other triggers can include:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Rheumatic disorders, such as <a href=\"https:\/\/ameripharmaspecialty.com\/other-health-conditions\/kawasaki-disease-10-frequently-asked-questions-answered\/\">Kawasaki Disease<\/a> and juvenile <a href=\"https:\/\/ameripharmaspecialty.com\/ivig\/ivig-for-systemic-lupus-erythematosus\/\">systemic lupus erythematosus<\/a><\/li>\n\n\n\n<li>Medications, such as aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs)<\/li>\n\n\n\n<li>Disease flares (worsening of symptoms of a chronic disease, especially <a href=\"https:\/\/ameripharmaspecialty.com\/ivig\/ivig-and-autoimmune-diseases\/\">autoimmune disorders<\/a>)<\/li>\n<\/ul>\n\n\n\n<p>The signs and symptoms of MAS can include:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Enlarged liver and spleen<\/li>\n\n\n\n<li>Worsening liver function<\/li>\n\n\n\n<li>Swollen lymph glands<\/li>\n\n\n\n<li>Constantly high fever<\/li>\n\n\n\n<li>Seizures and coma<\/li>\n\n\n\n<li>Anemia (low red blood cell count)<\/li>\n\n\n\n<li>Shock<\/li>\n\n\n\n<li>Rash<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Treatment_of_Macrophage_Activation_Syndrome\"><\/span>Treatment of Macrophage Activation Syndrome&nbsp;<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>There is no consensus about specific treatment for MAS.&nbsp;<\/p>\n\n\n\n<p>Before biologics came into existence, IVIG, glucocorticoids, and cyclosporine were widely used to treat rheumatic disease-associated MAS. Currently, these medications are used alone or in combination with biologic agents [<a href=\"https:\/\/ped-rheum.biomedcentral.com\/articles\/10.1186\/s12969-019-0309-6\">3<\/a>].<\/p>\n\n\n\n<div  id=\"call-to-action-8d658e65653164ffab05e1b2a75fdd45\" style=\"\" class=\"ct_call_to_action\">\n\t<div class=\"container\">\n\t\t<div class=\"block-wrap cta\">\n\t\t\t<div class=\"block-column\">\n\t\t\t\t<div class=\"cta_headings\">\n\t\t\t\t\t\t\t\t\t\t\t<h4 class=\"cta__heading\">\n\t\t\t\t\t\t\tGet Financial Assistance\t\t\t\t\t\t<\/h4>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<span class=\"cta_btn\">\n\t\t\t\t\t\t<a href=\"#form\">Schedule a Consultation<\/a>\n\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"IVIG_for_Macrophage_Activation_Syndrome_What_We_Know_So_Far\"><\/span>IVIG for Macrophage Activation Syndrome: What We Know So Far<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"alignright size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"420\" height=\"280\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2025\/12\/ivig-at-home.jpg\" alt=\"Patient receiving IVIG at home with the assistance of a nurse\" class=\"wp-image-27930\" srcset=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2025\/12\/ivig-at-home.jpg 420w, https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2025\/12\/ivig-at-home-300x200.jpg 300w, https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2025\/12\/ivig-at-home-18x12.jpg 18w, https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2025\/12\/ivig-at-home-330x220.jpg 330w, https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2025\/12\/ivig-at-home-86x57.jpg 86w, https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2025\/12\/ivig-at-home-167x111.jpg 167w, https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2025\/12\/ivig-at-home-280x187.jpg 280w, https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2025\/12\/ivig-at-home-370x247.jpg 370w\" sizes=\"auto, (max-width: 420px) 100vw, 420px\" \/><\/figure>\n<\/div>\n\n\n<p>IVIG may benefit some patients with MAS, especially when administered early. However, success and efficacy vary widely, and studies have found mixed results.&nbsp;<\/p>\n\n\n\n<p>For example, in a 2001 study, IVIG produced partial or delayed improvement in five patients but no effects in another five patients. The total number of participants in the study was 20.&nbsp;<\/p>\n\n\n\n<p>The researchers concluded that IVIG for macrophage activation syndrome might be an option when started during the early stages of macrophage activation [<a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ajh.1141\">4<\/a>].<\/p>\n\n\n\n<p>IVIG can be a first-line treatment for patients with chronic granulomatous disease (CGD) complicated by macrophage activation syndrome [<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/22119934\/\">5<\/a>].&nbsp;<\/p>\n\n\n\n<p>Researchers from a 2020 case report revealed that IVIG may be [<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/34520152\/\">6<\/a>]:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>First-line treatment for systemic lupus erythematosus (SLE) with macrophage activation syndrome.<\/li>\n\n\n\n<li>Second-line treatment with intravenous steroids.\u00a0<\/li>\n<\/ul>\n\n\n\n<p>Likewise, according to the 2022 EULAR\/American College of Rheumatology consensus statements, high-dose glucocorticoids, anakinra with or without IVIG, could be the initial treatment for people with rapidly progressive MAS [<a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC11017727\/\">7<\/a>].&nbsp;<\/p>\n\n\n\n<p>Available evidence suggests that the effectiveness of IVIG for macrophage activation syndrome is case-dependent.&nbsp;<\/p>\n\n\n\n<p>For example, IVIG appears to be less effective in severe or refractory cases. However, IVIG therapy should be considered for patients who are unable to receive immunosuppressive medications. IVIG is usually preferred when a patient is moderately ill and has an underlying infection.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"IVIG_for_Macrophage_Activation_Syndrome_Understanding_the_Mechanism_of_Action\"><\/span>IVIG for Macrophage Activation Syndrome: Understanding the Mechanism of Action<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>The exact mechanism of action of IVIG for macrophage activation syndrome is poorly understood.&nbsp;<\/p>\n\n\n\n<p>IVIG is thought to improve MAS symptoms by [<a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC7062444\/\">8<\/a>,<a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC6978335\/\">9<\/a>]:&nbsp;<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Suppressing macrophage activation and release of inflammatory substances.<\/li>\n\n\n\n<li>Activating macrophages to release large amounts of anti-inflammatory molecules.<\/li>\n\n\n\n<li>Promoting degradation of inflammation-causing macrophages.\u00a0<\/li>\n<\/ul>\n\n\n\n<p>There is no specific dose, which likely depends on the underlying illness and the patient\u2019s response. For moderately ill patients, the usual dose is 1 g to 2\u2009g\/kg\/dose IV [<a href=\"https:\/\/ped-rheum.biomedcentral.com\/articles\/10.1186\/s12969-019-0309-6\">3<\/a>].<\/p>\n\n\n\n<div  id=\"call-to-action-b508dc331e380baa50c27f2c15e9c07c\" style=\"\" class=\"ct_call_to_action\">\n\t<div class=\"container\">\n\t\t<div class=\"block-wrap cta\">\n\t\t\t<div class=\"block-column\">\n\t\t\t\t<div class=\"cta_headings\">\n\t\t\t\t\t\t\t\t\t\t\t<h4 class=\"cta__heading\">\n\t\t\t\t\t\t\tGet Copay Assistance Now\t\t\t\t\t\t<\/h4>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<span class=\"cta_btn\">\n\t\t\t\t\t\t<a href=\"tel:8777780318\">(877) 778-0318<\/a>\n\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Frequently_Asked_Questions\"><\/span>Frequently Asked Questions<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<h4 class=\"wp-block-heading\">What are the treatment options for MAS?<\/h4>\n\n\n\n<p>Treatment options for MAS are IVIG, glucocorticoids, cyclosporine, plasma exchange, and anakinra.&nbsp;<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">What is the difference between MAS and HLH?<\/h4>\n\n\n\n<p>Macrophage activation syndrome (MAS) and <a href=\"https:\/\/ameripharmaspecialty.com\/other-health-conditions\/hemophagocytic-lymphohistiocytosis-hlh\/\">hemophagocytic lymphohistiocytosis <\/a>(HLH) are potentially fatal conditions with overlapping symptoms. Nonetheless, MAS is usually associated with rheumatologic disorders, such as systemic juvenile idiopathic arthritis (sJIA), while HLH is often associated with viral infections, cancers, and certain medications [<a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC7153684\/\">10<\/a>].<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">What is MAS in systemic JIA?<\/h4>\n\n\n\n<p>MAS is a potentially fatal complication of systemic juvenile idiopathic arthritis (s-JIA). Studies show that 1 in 10 children with s-JIA develops MAS.&nbsp;<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">What is the life expectancy in macrophage activation syndrome (MAS)?<\/h4>\n\n\n\n<p>In a 2022 study involving 20 adults with rheumatic disease-associated MAS, overall survival at 3 and 6 months was 75.2% and 64.3%, respectively. During the study period, opportunistic infections affected nine participants, and five of them died [<a href=\"https:\/\/journals.plos.org\/plosone\/article?id=10.1371\/journal.pone.0267715\">11<\/a>].<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">What are the FDA-approved IVIG products for macrophage activation syndrome (MAS)?<\/h4>\n\n\n\n<p>The FDA has not yet approved any IVIG product for macrophage activation syndrome (MAS). Currently, IVIG use is off-label. In the U.S., the only FDA-approved treatment for MAS is Gamifant (emapalumab-lzsg), which is an interferon gamma-blocking antibody.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>La inmunoglobulina intravenosa (IVIG) para el s\u00edndrome de activaci\u00f3n macrof\u00e1gica (SAM) puede ser una opci\u00f3n cuando los pacientes no pueden usar otros medicamentos inmunosupresores. Descubra c\u00f3mo funciona la IVIG, conozca sus posibles beneficios y encuentre respuestas a sus preguntas m\u00e1s frecuentes.<\/p>","protected":false},"author":26,"featured_media":27929,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"om_disable_all_campaigns":false,"_uag_custom_page_level_css":"","footnotes":""},"categories":[7],"tags":[32],"class_list":["post-27928","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-ivig","tag-dr-robert-hakim"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>When to Consider IVIG for Macrophage Activation Syndrome (MAS): Key Insights, Based on the Latest Evidence<\/title>\n<meta name=\"description\" content=\"Learn when IVIG may help macrophage activation syndrome (MAS), how it works, dosing basics, FAQs and what current 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