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Randomised trial of intravenous immunoglobulin maintenance treatment regimens in chronic inflammatory demyelinating polradiculoneuropathy

European Journal of Neurology Sep 07, 2020

Kuitwaard R, Brusse E, Jacobs BC, et al. - In chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), high peak serum IgG levels may not be required for maintenance treatment of intravenous immunoglobulin (IVIg) and cause side‐effects. Considering that more frequent reduction in dose may result in more stable IgG levels and greater trough levels which might enhance its efficacy, researchers conducted a randomized placebo‐controlled cross‐over trial including 25 CIDP patients. Patients in the control arm received their individual IVIg dose and interval followed by a placebo infusion at half the interval and patients in the intervention arm received half their individual dose at half the interval. Patients crossed‐over after a wash‐out phase. Treatment was provided at baseline with individual adjusted dosages of IVIg ranging from 20‐80 grams and intervals ranging from 14‐35 days. Outcomes revealed neither further improvement in the efficacy of IVIg nor reduced side effects in correlation with more frequent lower dosing among stable IVIg dependent CIDP.

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