Subcutaneous versus intravenous immunoglobulin for chronic autoimmune neuropathies: A meta‐analysis

Racosta, Juan Manuel; Sposato, Luciano A.; Kimpinski, Kurt

doi:10.1002/mus.25409

Cited by 66 publications

(58 citation statements)

References 38 publications

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“…Thus, immunoglobulin G level monitoring might be helpful in establishing optimum treatment management . Subcutaneous immunoglobulins have recently been proposed as an alternative treatment for MMN and CIDP . Their use was not common in our study but things may have changed.…”

Section: Discussionmentioning

confidence: 76%

Intravenous immunoglobulin for treatment of chronic inflammatory demyelinating polyneuropathy and multifocal motor neuropathy in France: are daily practices in accordance with guidelines?

Rosier

Graveline

Lacour

et al. 2018

Euro J of Neurology

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Background and purpose Chronic inflammatory demyelinating polyneuropathy (CIDP) and multifocal motor neuropathy (MMN) are rare autoimmune diseases. Guidelines were published in 2010 for their diagnosis and treatment. In France, intravenous immunoglobulins (IVIGs) are mainly used for the first‐line treatment. The burden of healthcare costs is often underlined but rarely studied. The aim of this survey was to compare to guidelines, the daily practice of French neurologists with IVIGs for CIDP and MMN treatment. Methods This was a retrospective observational study consisting of an online questionnaire performed between March and May 2014. A total of 49 questionnaires were included, a quarter of which were from neurologists working in neuromuscular reference centers (NRCs). Results A total of 182 patient case reports were studied. Patients were referred to an NRC for initial diagnosis in approximately 30% of cases in CIDP and 50% of cases in MMN. The initial management of IVIG (frequency, dose and duration) was not different between NRCs and non‐NRCs. Guidelines were followed and neurologists were relatively at ease in diagnosing and treating patients. Conclusions This was the first national study to describe the implementation of the European Federation of Neurological Sciences/Peripheral Nerve Society guidelines in the daily management of IVIGs in patients with MMN and CIDP in France. Efforts are needed to improve long‐term tailored treatment and home treatment to reduce economic costs.

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Section: Discussionmentioning

confidence: 76%

Intravenous immunoglobulin for treatment of chronic inflammatory demyelinating polyneuropathy and multifocal motor neuropathy in France: are daily practices in accordance with guidelines?

Rosier

Graveline

Lacour

et al. 2018

Euro J of Neurology

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“…Twenty of 29 participants said that they preferred subcutaneous to intravenous immunoglobulin. A recent meta-analysis concluded that subcutaneous and intravenous immunoglobulin are equally effective in CIDP and in multifocal motor neuropathy (Racosta 2016). The ongoing Van Schaik 2016 RCT is also investigating the efficacy of subcutaneous immunoglobulin and the next updates of Eftimov 2013 and this overview will include this trial.…”

Section: Discussionmentioning

confidence: 99%

Treatments for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP): an overview of systematic reviews

Oaklander

Lunn

Hughes

et al. 2017

Cochrane Database of Systematic Reviews

119

142

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“…Long‐term subcutaneous immunoglobulin (LT‐SCIg) is a safe, effective, and tolerable alternative therapy in patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) . The lower profile of side effects when compared with intravenous immunoglobulin (IVIg) and its comparable clinical efficacy, together with lower direct (drugs for premedication, health‐care professional time) and indirect costs (eg, loss of working time for the patient/caregiver, transport), make this treatment widely accepted and well tolerated, even for long‐term treatment. The large PATH trial in CIDP patients demonstrated that LT‐SCIg for 24 weeks can be used as a maintenance treatment in patients with CIDP .…”

Section: Introductionmentioning

confidence: 99%

Clinical‐neurophysiological correlations in chronic inflammatory demyelinating polyradiculoneuropathy patients treated with subcutaneous immunoglobulin

et al. 2019

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Introduction Despite the well‐described clinical efficacy of long‐term subcutaneous immunoglobulin (LT‐SCIg) in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) patients, the neurophysiological effects of SCIg have been followed only for a short time and were not correlated with clinical parameters. Methods Fourteen CIDP patients were evaluated at baseline and after LT‐SCIg administration for 24 to 48 months. Nerve conduction studies were performed and clinical features were assessed for: (a) overall strength, by Medical Research Council sum score; (b) sensory function, by Inflammatory Neuropathy Cause And Treatment score; (c) disability, by Rasch‐built overall disability scale; (d) quality of life (QoL), by the EuroQol Visual Analog Scale. Results LT‐SCIg treatment improved clinical and neurophysiological features, preserving strength and improving sensory deficits, disability, and QoL. Clinical scores correlated with the amplitude of distal motor action (dCMAP) and sensory nerve action (SNAP) potentials. Discussion LT‐SCIg treatment demonstrates efficacy in maintaining and continuing clinical improvement at 24 to 48 months after start of treatment. dCMAP and SNAP amplitudes represent useful prognostic factors for functional outcome.

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Subcutaneous versus intravenous immunoglobulin for chronic autoimmune neuropathies: A meta‐analysis

Abstract: The efficacy of SC-Ig is similar to IVIg for CIDP and MMN and has a significant safety profile. Muscle Nerve 55: 802-809, 2017.

Cited by 66 publications

References 38 publications

Intravenous immunoglobulin for treatment of chronic inflammatory demyelinating polyneuropathy and multifocal motor neuropathy in France: are daily practices in accordance with guidelines?

Intravenous immunoglobulin for treatment of chronic inflammatory demyelinating polyneuropathy and multifocal motor neuropathy in France: are daily practices in accordance with guidelines?

Treatments for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP): an overview of systematic reviews

Clinical‐neurophysiological correlations in chronic inflammatory demyelinating polyradiculoneuropathy patients treated with subcutaneous immunoglobulin

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