Intravenous Immunoglobulin (IVIG) as a Treatment for Neurological Disorders

Intravenous immunoglobulin (IVIG) has been used to treat autoimmune conditions for years, and it is now being explored as a treatment for certain neurological diseases. Recent research has investigated IVIG in conditions such as multifocal motor neuropathy (MMN), Guillain-Barre syndrome (GBS), and chronic inflammatory demyelinating polyneuropathy (CIDP). The journal Neurotherapeutics has published a paper that illustrates the data in regard to IVIG and neurological disorders.

IVIG for Neurological Disorders

According to the National Institutes of Health,

Intravenous immunoglobulin (IVIG) is a blood product prepared from the serum of between 1000 and 15 000 donors per batch. It is the treatment of choice for patients with antibody deficiencies.

Within IVIG, there are a number of antibodies that protect against various pathogens, along with other foreign and self-antigens. In the past, it has been shown to provide positive results in the treatment of painful, neuroinflammatory, and neurodegenerative disorders. However, when it is used for these indications, it is done off-label.

Within the paper, researchers outlined multiple controlled and randomized clinical trials that demonstrate IVIG’s effects on neurological conditions. For example, several trials have investigated IVIG vs. plasmapheresis in regard to GBS. They found favorable results, with one dose of IVIG matching the current standard of care in terms of discontinuation of ventilation and unaided walking. In addition, doctors have noted that IVIG provides positive results in GBS variants, such as Miller-Fisher syndrome, although it has not yet been evaluated in clinical trials.

Looking to CIDP, studies have shown that IVIG has the same effect as plasmapheresis and steroids in the short-term. Further research proved that it maintains this efficacy, as well as safety, in the long-term. Doctors who prescribe this treatment off-label have stated that different patients respond to different methods, so all three should continue to be used. More research is needed to understand why this is.

On the other hand, MMN patients only responded to IVIG in comparison to steroids and plasmapheresis. Multiple clinical trials have shown the efficacy of this treatment, leading the FDA to approve Baxter’s IVIG product. MMN patients will need infusions every three to six weeks, with an initial dose of 2 g/k but a maintenance dose of 1 g/k.

The paper explores other neurological conditions that may benefit from IVIG, but to date, there is not sufficient data to recommend it as a treatment. You can find the source article here.

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