Abstract
Intravenous immunoglobulin (IVIg) has been extensively used to treat humoral immunodeficiency states and various immune-mediated conditions. Several studies indicate that the benefits of IVIg with respect to relapses and MRI lesion activity compare favorably with those of interferon β and glatiramer acetate in relapsing–remitting multiple sclerosis (RRMS) or clinically isolated syndromes. Fazekas et al. recently reported the results of a multinational, randomized, double-blind, placebo-controlled phase II trial of a new preparation of IVIg in 127 participants with RRMS. No significant benefit was demonstrated for IVIg compared with placebo for the primary end point (proportion of relapse-free participants), the main secondary end point (cumulative number of unique newly active brain MRI lesions), or a number of clinical and MRI tertiary end points. Neither the previous positive studies nor the negative results reported by Fazekas et al. can be considered to be definitive, and the utility of IVIg in RRMS remains uncertain at present.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$209.00 per year
only $17.42 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
References
Brannagan TH et al. (1996) Complications of intravenous immune globulin treatment in neurologic disease. Neurology 47: 674–677
Stangel M et al. (1999) Mechanisms of high-dose intravenous immunoglobulins in demyelinating diseases. Arch Neurol 56: 661–663
Fazekas F et al. (1997) Randomized placebo-controlled trial of monthly intravenous immunoglobulin therapy in relapsing–remitting multiple sclerosis. Lancet 349: 589–593
Achiron A et al. (1998) Intravenous immunoglobulin treatment in multiple sclerosis: effect on relapses. Neurology 50: 398–402
Sorensen PS et al. (1998) Intravenous immunoglobulin G reduces MRI activity in relapsing multiple sclerosis. Neurology 50: 1273–1281
Lewanska M et al. (2002) No difference in efficacy of two different doses of intravenous immunoglobulins in MS: clinical and MRI assessment. Eur J Neurol 9: 565–572
Achiron A et al. (2004) Intravenous immunoglobulin treatment following the first demyelinating event suggestive of multiple sclerosis: a randomized, double-blind, placebo-controlled trial. Arch Neurol 61: 1515–1520
Fazekas F et al. (2008) Intravenous immunoglobulin in relapsing–remitting multiple sclerosis: a dose-finding trial. Neurology 71: 265–271
Author information
Authors and Affiliations
Ethics declarations
Competing interests
JA Cohen has acted as a consultant for and has received research support from Biogen Idec, Genzyme, Novartis and Teva, has acted as a consultant for Eisai, Eli Lilly, Genentech, GlaxoSmithKline, IMPAX, Incyte, Schering Plough and Wyeth, and has received research support from Artielle, BioMS, Immune Tolerance Network, Nancy Davis Center Without Walls, the National Multiple Sclerosis Society and Orchestra Therapeutics.
Rights and permissions
About this article
Cite this article
Cohen, J. How effective is intravenous immunoglobulin for the treatment of relapsing–remitting multiple sclerosis?. Nat Rev Neurol 4, 588–589 (2008). https://doi.org/10.1038/ncpneuro0923
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/ncpneuro0923
This article is cited by
-
Immunoglobulins for primary or secondary immunodeficiency or for immunomodulation in neurological autoimmune diseases: insights from the prospective SIGNS registry
Journal of Public Health (2012)
-
Novel therapeutic strategies for multiple sclerosis: potential of intravenous immunoglobulin
Nature Reviews Drug Discovery (2009)