Randomised placebo-controlled trial of monthly intravenous immunoglobulin therapy in relapsing-remitting multiple sclerosis

Fazekas, Franz; Deisenhammer, Florian; Strasser-Fuchs, Siegrid; Nahler, Gerhard; Mamoli, B.

doi:10.1016/s0140-6736(96)09377-4

Cited by 358 publications

(190 citation statements)

References 28 publications

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“…On present evidence, i.v. immunoglobulin therapy may be as effective as interferon beta in the treatment of relapsingremitting MS, 50 but further studies are needed to determine the effects of its long-term use in MS.…”

Section: IV Immunoglobulin Therapymentioning

confidence: 99%

Recent progress in the diagnosis and treatment of multiple sclerosis

Pender

1999

Journal of Clinical Neuroscience

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Magnetic resonance imaging (MRI) now provides valuable diagnostic and prognostic information for the management of multiple sclerosis (MS) but the diagnosis still largely rests on the clinical features of central nervous system (CNS) lesions disseminated in time and place. Recent histological and MRI studies indicate that extensive axonal damage can occur in MS, even early in the disease course, and is likely to be an important cause of accumulating disability. Several immunomodulating agents have now been shown to have beneficial effects in MS. High dose intravenous or high dose oral methylprednisolone therapy accelerates recovery from attacks of relapsing-remitting MS, but at present there is no convincing evidence that standard dose (intermediate dose) oral corticosteroid therapy is beneficial for such attacks. Interferon beta, copolymer 1 (glatiramer acetate) and i.v. immunoglobulin therapy each significantly reduce the frequency of attacks of relapsing-remitting MS. Interferon beta also inhibits the progression of disability in relapsing-remitting MS and secondary progressive MS, but its effect on primary progressive MS is unknown. Oral low dose methotrexate therapy slows the progression of disability in secondary progressive MS and possibly in primary progressive MS, but it is likely that the currently used dosage (7.5 mg weekly) is suboptimal. Further research is needed to determine the optimal doses and combinations of the above therapies in MS and to develop better therapies, particularly for primary progressive MS.

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Section: IV Immunoglobulin Therapymentioning

confidence: 99%

Recent progress in the diagnosis and treatment of multiple sclerosis

Pender

1999

Journal of Clinical Neuroscience

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“…Mothers with MS are interested in reducing the probability of experiencing postpartum relapses in order to best manage with their child, but treatment with DMTs is not recommended during nursing. One therapeutic option is IVIg, which is safe to use during breastfeeding, and which has been suggested to reduce disease activity in MS, 39 although in a later study no benefit could be demonstrated. 40 A retrospective study however suggested that IVIg may be effective in preventing postpartum relapses.…”

Section: Treatment Of Postpartum Relapsementioning

confidence: 99%

Pregnancy and multiple sclerosis

Airas

Kaaja

2012

Obstet Med

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Summary:The relapse rate of multiple sclerosis (MS) is typically reduced during late pregnancy but increases in the postpartum period. The reasons for the increased postpartum activity are not entirely clear, but factors such as the abrupt decrease in oestrogen levels immediately after the delivery and the loss of the immunosuppressive state of pregnancy are likely of importance. There is a general view that MS does not affect the course or outcome of pregnancy.

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“…For example, in relapsing-remitting multiple sclerosis, an RCT involving 150 patients showed no improvement in the occurrence of relapses with immunoglobulin versus placebo. 37 Immunoglobulin was found to be ineffective in secondary progressive multiple sclerosis in a placebocontrolled RCT involving 197 patients. 38 A recent placebo-controlled RCT failed to show a beneficial effect in Alzheimer disease.…”

Section: For Which Diseases Is Intravenous Immunoglobulin Not Recommementioning

confidence: 99%