Treatment of Neurological Autoimmune Diseases with Immunoglobulins: First Insights from the Prospective SIGNS Registry

Stangel, Martin; Baumann, Ulrich; Borte, Michael; Faßhauer, Maria; Hensel, Manfred; Huscher, Dörte; Kirch, Wilhelm; Pittrow, David; Reiser, Marcel; Gold, Ralf

doi:10.1007/s10875-012-9789-6

Cited by 7 publications

(3 citation statements)

References 19 publications

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“…Comparative studies of PLEX/IA and IVIG have produced comparable results in both treatment groups, although in individual cases a delayed effect of IVIG (up to 2 weeks) or even an initial deterioration ("dip" similar to the initiation phase of cortisone therapy) has been reported. The typical IVIG dose is 0.4 g/ kg body weight (bw), on each of five successive days [7,13,15].…”

Section: Immunoglobulinsmentioning

confidence: 99%

Myasthenia Gravis – Exacerbation and Crisis

Schroeter

Kaiser

2018

Neurology International Open

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Myasthenic exacerbation and crisis are most critical incidences in myasthenia gravis. Even nowadays myasthenic crisis is a life-threatening condition, with a lethality of 2–3%. We review means of avoiding myasthenic exacerbation and crisis, elaborate on red flags and how to establish highly-active therapy in a timely manner. This includes the reasonable use of cholinesterase inhibitors, immunoadsorption or plasma exchange, as well as immunoglobulins and steroids. Immunosuppressive agents and monoclonal antibody therapy add to the therapeutic options.Intensive care of myasthenic patients includes the management of dysphagia and delirium. Importantly, the perioperative management of patients undergoing thymectomy and weaning are specific challenges in the treatment of myasthenic patients in the ICU.Establishing timely consequent immunosuppression and treatment of myasthenic patients in specialized outpatient centres help to avoid repetitive exacerbations and crises.

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Section: Immunoglobulinsmentioning

confidence: 99%

Myasthenia Gravis – Exacerbation and Crisis

Schroeter

Kaiser

2018

Neurology International Open

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“…Overall, IVIG has been most commonly used for neurologic indications (43% by volume), followed by immunology (33%), and hematology and oncology (combined 19%) . In neurologic clinical practice, IVIG is used as an immunomodulating treatment of various autoimmune disorders, both as an acute therapy and as a long‐term maintenance therapy (Table ) . Complex physiology and pharmacology of IVIG are still only partially understood, and multiple mechanisms of actions have been proposed (Table ) .…”

Section: Introductionmentioning

confidence: 99%

Intravenous immunoglobulin in the treatment of neurologic disorders

Živković

2015

Acta Neurol Scand

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Intravenous immunoglobulins (IVIGs) are often used in the treatment of autoimmune disorders and immunodeficiencies, and it has been estimated that neurologic indications can account for up to 43% of IVIG used in clinical practice. In neurologic clinical practice, IVIG is used for acute therapy of newly diagnosed autoimmune disorders or exacerbations of pre-existing conditions, or as long-term maintenance treatment for chronic disorders. IVIG exerts its effects on humoral and cell-based immunity through multiple pathways, without a single dominant mechanism. Clinical use of IVIG has been supported by guidelines from American Academy of Neurology and European Federation of Neurologic Societies. IVIG is generally recommended for the treatment of Guillain-Barre syndrome and chronic inflammatory demyelinating polyneuropathy in adults, multifocal motor neuropathy and myasthenia gravis, and should be considered as a treatment option for dermatomyositis in adults and Lambert-Eaton myasthenic syndrome. Additional potential indications include stiff person syndrome, multiple sclerosis during pregnancy or while breastfeeding, refractory autoimmune epilepsy, and paraneoplastic disorders. Clinical use of IVIG is mostly safe but few adverse effects may still occur with potentially severe complications, including aseptic meningitis and thromboembolism. In addition to intravenous route (IVIG), subcutaneous immunoglobulins have been used as an alternative treatment option, especially in patients with limited intravenous access. Treatment with IVIG is effective in various autoimmune diseases, but its broader use is constrained by limited supply. This review evaluates the use of immunoglobulins in treatment of neurologic diseases.

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“…The main advantage of these microparticles is their biodegradability, as it is not necessary to remove them through surgery even when the therapy is completed. The microparticles not only protect the drug from degradation and/or inactivation, but also do not require the use of solvents for their administration 23,24…”

Section: Introductionmentioning

confidence: 99%

Evaluation of ceftiofur–PHBV microparticles in rats

Vilos¹,

Constandil²,

Rodas³

et al. 2014

DDDT

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Despite the high number of antibiotics used for the treatment of infectious disease in animals, the development of slow release formulations presents a significant challenge, particularly in using novel biomaterials with low cost. In this report, we studied the pharmacokinetics, toxicity, and therapeutic activity of ceftiofur–PHBV (ceftiofur–poly(3-hydroxybutyrate-co-3-hydroxyvalerate)) in rats. The pharmacokinetic study demonstrated a sustained release of ceftiofur into the bloodstream, with detectable levels over the minimum inhibitory concentration for at least 17 days after a single intramuscular injection of ceftiofur–PHBV (10 mg/kg weight). In addition, the toxicological evaluation of biochemical, hematological, and coagulation blood parameters at the therapeutic dose demonstrated the safety of ceftiofur–PHBV, with no adverse effects. In addition, ceftiofur–PHBV exhibited a therapeutic effect for a longer time period than the nonencapsulated ceftiofur in rats challenged with Salmonella Typhimurium. The slow release of ceftiofur from the ceftiofur–PHBV, its low toxicity in the blood parameters evaluated, and the efficacy in the rats infected with Salmonella Typhimurium make ceftiofur–PHBV a strong candidate for biotechnological applications in the veterinary industry.

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Treatment of Neurological Autoimmune Diseases with Immunoglobulins: First Insights from the Prospective SIGNS Registry

Cited by 7 publications

References 19 publications

Myasthenia Gravis – Exacerbation and Crisis

Myasthenia Gravis – Exacerbation and Crisis

Intravenous immunoglobulin in the treatment of neurologic disorders

Evaluation of ceftiofur–PHBV microparticles in rats

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Treatment of Neurological Autoimmune Diseases with Immunoglobulins: First Insights from the Prospective SIGNS Registry

Cited by 7 publications

References 19 publications

Myasthenia Gravis – Exacerbation and Crisis

Myasthenia Gravis – Exacerbation and Crisis

Intravenous immunoglobulin in the treatment of neurologic disorders

Evaluation of ceftiofur&ndash;PHBV microparticles in rats

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Evaluation of ceftiofur–PHBV microparticles in rats