Objective:

To systematically evaluate the efficacy and safety of immunoadsorption combined with immunoglobulin G replacement therapy (IA/IG) in treating dilated cardiomyopathy (DCM).

Approach:

Key Findings:

• IA/IG therapy significantly improved left ventricular ejection fraction (LVEF) by 7.71% (95% CI: 6.18–9.24, p < 0.00001).
• IA/IG therapy reduced left ventricular end-diastolic dimension (LVEDD) by 3.22 mm (95% CI: −4.16 to −2.28, p < 0.00001).
• Improvements were also noted in NYHA functional class (MD = −0.76, 95% CI: −0.91 to −0.60, p < 0.00001) and peak VO₂ (MD = 2.66 mL/kg/min, 95% CI: 1.26–4.06, p = 0.0002).
• IA/IG group showed greater improvement in LVEF (MD = 8.31%, 95% CI: 6.45–10.18, p < 0.00001) and NYHA class (MD = –0.62, 95% CI: −1.00 to −0.25, p = 0.001) compared to controls.
• Results were stable according to sensitivity analysis.

Interpretation:

IA/IG therapy may improve cardiac function and quality of life in patients with DCM, but results should be interpreted with caution due to the limited number of RCTs.

Limitations:

• Limited number of randomized controlled trials included in the study.
• Variability in study design and patient populations across included studies.

Conclusion:

Further high-quality, large-scale trials are warranted to establish standardized treatment protocols and confirm the long-term benefits of IA/IG therapy.

Sources:

• Systematic Review Registration
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