Thromboembolic complications of intravenous immunoglobulin therapy in patients with neuropathy: A two-year study

Rajabally, Yusuf A.; Kearney, David

doi:10.1016/j.jns.2011.05.035

Cited by 59 publications

(61 citation statements)

References 18 publications

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“…Types of AR observed were similar to those previously reported . Without a control group we cannot determine whether these events are definite side effects.…”

Section: Discussionsupporting

confidence: 84%

Safety of intravenous immunoglobulin in the elderly treated for a dysimmune neuromuscular disease

Lozeron¹,

Not²,

Théaudin³

et al. 2016

Muscle and Nerve

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“…Types of AR observed were similar to those previously reported . Without a control group we cannot determine whether these events are definite side effects.…”

Section: Discussionsupporting

confidence: 84%

Safety of intravenous immunoglobulin in the elderly treated for a dysimmune neuromuscular disease

Lozeron¹,

Not²,

Théaudin³

et al. 2016

Muscle and Nerve

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“…IVIg remains in the majority of institutions more practical, being of easier access and administration. PE, the originally trialed therapy is however an efficacious treatment which should probably be opted for when there are major specific contra-indications to IVIg, such as a very high thromboembolic risk [48]. Access issues counterbalance the moderate cost benefits of PE over IVIg as may exist in some countries.…”

Section: Resultsmentioning

confidence: 99%

Treatment of Guillain-Barre Syndrome: A Review

Rajabally

2012

IADT

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Guillain-Barré syndrome is a frequently post-infectious, autoimmune acute inflammatory polyradiculoneuropathy affecting all age groups. It typically results in rapid-onset weakness symmetrically affecting proximal and distal muscles. Cranial muscles are not infrequently affected and respiratory muscle weakness requiring mechanical ventilation occurs in 25% of cases. The incidence is around 1-2 per 100,000/year. Various clinical, electrophysiological and immunological subtypes are described. Plasma exchanges (PE) and intravenous immunoglobulins (IVIg) represent the main treatment options. PE were shown to be effective on rate of recovery in randomized trials. Subsequently further trials have demonstrated the equivalence of IVIg. IVIg are frequently the preferred option for practical reasons. Treatment can result in reversible clinical fluctuations which need to be readily recognized. Although number of PE appears to be optimally of 4, except in mildly affected patients where only 2 may suffice, the dosage of IVIg conventionally administered (2 g/kg) may be sub-optimal in some patients. This may relate to a relationship between IVIg pharmacokinetics and clinical outcome. Studies are under way to evaluate the usefulness of a second IVIg course in severely-affected GBS patients. There is no evidence for use of corticosteroids in GBS. Both IVIg and PE are costly and despite their use and established effectiveness, there is still a need for new treatments to lessen disability. Further research is warranted in optimizing currently available therapies as well as finding others to effectively improve the management of this potentially devastating condition.

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“…Pre-existing vascular disease and immobility, additional factors that increase the risk for thromboembolic events [20], are often present in elderly individuals, including those with AD [21,22]. In patients with neuropathies that received IVIG, immobility was found to be an independent predictor for the development of thromboemboli [23]. Vascular disease and immobility in AD patients could therefore increase the risk of these individuals for IVIG-induced thromboembolic events.…”

Section: Considerations Relating To Treatment Of Ad With Ivig Productsmentioning

confidence: 99%

Intravenous immunoglobulin and Alzheimer’s disease: what now?

Loeffler

2013

J Neuroinflammation

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Intravenous immunoglobulin (IVIG) products are prepared from purified plasma immunoglobulins from large numbers of healthy donors. Pilot studies with the IVIG preparations Octagam and Gammagard in individuals with mild-to-moderate Alzheimer’s disease (AD) suggested stabilization of cognitive functioning in these patients, and a phase II trial with Gammagard reported similar findings. However, subsequent reports from Octagam’s phase II trial and Gammagard’s phase III trial found no evidence for slowing of AD progression. Although these recent disappointing results have reduced enthusiasm for IVIG as a possible treatment for AD, it is premature to draw final conclusions; a phase III AD trial with the IVIG product Flebogamma is still in progress. IVIG was the first attempt to use multiple antibodies to treat AD. This approach should be preferable to administration of single monoclonal antibodies in view of the multiple processes that are thought to contribute to AD neuropathology. Development of “AD-specific” preparations with higher concentrations of selected human antibodies and perhaps modified in other ways (such as increasing their anti-inflammatory effects and/or ability to cross the blood–brain barrier) should be considered. Such preparations, if generated with recombinant technology, could overcome the problems of high cost and limited supplies, which have been major concerns relating to the possible widespread use of IVIG in AD patients. This review summarizes the recent AD IVIG trials and discusses the major issues relating to possible use of IVIG for treating AD, as well as the critical questions which remain.

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Thromboembolic complications of intravenous immunoglobulin therapy in patients with neuropathy: A two-year study

Cited by 59 publications

References 18 publications

Safety of intravenous immunoglobulin in the elderly treated for a dysimmune neuromuscular disease

Safety of intravenous immunoglobulin in the elderly treated for a dysimmune neuromuscular disease

Treatment of Guillain-Barre Syndrome: A Review

Intravenous immunoglobulin and Alzheimer’s disease: what now?

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