Long-term effects of intravenous immunoglobulin in CIDP

Acute motor response following a single IVIG treatment course in chronic inflammatory demyelinating polyneuropathy

“…In a recent study of 1 year of maintenance therapy of IVIG, proximal as well as distal CMAP increased in combination with a decrease of spontaneous EMG activity. 33 All in all, these findings suggest that IVIG facilitates remyelination and reinnervation on a long-term basis.…”

“…33 In a recent study, maintenance therapy at a standard dose of 1.0 g/kg/3 weeks was proven to be effective, 18 but, in general, individual titration of dose and interval is recommended. 17 Although CIDP is considered to be a chronic disease, it is well known that most patients will obtain remission after a few years of treatment.…”

“…33 A severe relapse caused by withdrawal of therapy might cause irre- versible changes. Therefore, close surveillance is needed to avoid deterioration during discontinuation of therapy.…”

Nerve excitability changes after intravenous immunoglobulin infusions in multifocal motor neuropathy and chronic inflammatory demyelinating neuropathy

“…This could also support protective effects of IVIgs in the long-term, as intraaxonal Na + accumulation associated with energetic failure is known to lead to axonal degeneration in inflammatory demyelinating processes [34,35]. The neuroprotective value of IVIg infusions was suggested by the finding of long-term functional stability in patients treated by high and frequent doses of IVIgs [36,37]. The respective contribution of changes in passive membrane properties and decreased persistent Na + current could be more specifically addressed by the technique of latent addition [31] that has been recently applied to investigate peripheral neuropathies in humans [38,39].…”

Overview of the pathogenesis and treatment of chronic inflammatory demyelinating polyneuropathy with intravenous immunoglobulins

“…However, it remains unclear whether continuous treatment may have long-term favorable effects and maintaining patients on lower doses of IVIg may as a result in further deterioration so that dosing should be directed at maintaining maximal function. 59 CIDP patients on IVIg often receive their infusions as in-patients, which adds to the drug costs. Subcutaneous immunoglobulins is an alternative which can be self-administered by patients at home.…”