Subcutaneous immunoglobulin dose titration to clinical response in inflammatory neuropathy.
Chronic inflammatory demyelinating polyradiculoneuropathy
Immunoglobulin
Immunology
Peripheral neuropathy
Subcutaneous
Journal
Journal of neurology
ISSN: 1432-1459
Titre abrégé: J Neurol
Pays: Germany
ID NLM: 0423161
Informations de publication
Date de publication:
Apr 2021
Apr 2021
Historique:
received:
12
07
2020
accepted:
15
11
2020
revised:
28
09
2020
pubmed:
21
2
2021
medline:
22
6
2021
entrez:
20
2
2021
Statut:
ppublish
Résumé
Individualized dosing is an established approach in intravenous immunoglobulin (IVIg) treatment for inflammatory neuropathies. There is less experience in effective dosing strategies for subcutaneous (SC) immunoglobulin. We conducted a retrospective cohort study of patients with inflammatory neuropathies transferring from IVIg to SCIg in two UK peripheral nerve services. I-RODS and grip strength were used to measure outcome. Dose and clinical progress were documented at 1 year and at last review. 44/56 patients remained on maintenance SCIg beyond 1 year (mean 3.3 years, range 1-9 years) with stable clinical outcomes. Clinical deteriorations were corrected by small increases in SCIg dose in 20 patients at 1 year, a further 9 requiring subsequent further up-titrations. Sixteen tolerated dose reduction. Mean dose change was + 2.4% from baseline. Two patients required IVIg bolus rescue (2 g/kg). Three patients successfully discontinued Ig therapy. Nine patients returned to IVIg due to clinical relapse or patient preference. Overall tolerance was good. Dose titration to clinical response is an effective approach in SCIg maintenance therapy.
Identifiants
pubmed: 33608795
doi: 10.1007/s00415-020-10318-3
pii: 10.1007/s00415-020-10318-3
doi:
Substances chimiques
Immunoglobulins, Intravenous
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1485-1490Références
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