Subcutaneous immunoglobulin dose titration to clinical response in inflammatory neuropathy
| Autor: | Hadi Manji, Sarah Morrow, David Gosal, Mahima Kapoor, Aisling Carr, Ryan Keh, Mary M. Reilly, T. Lavin, L. Compton, Michael P. Lunn |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Neurology biology business.industry Retrospective cohort study medicine.disease 03 medical and health sciences Grip strength 0302 clinical medicine Peripheral neuropathy Bolus (medicine) Maintenance therapy Anesthesia medicine biology.protein 030212 general & internal medicine Neurology (clinical) Dosing Antibody business 030217 neurology & neurosurgery |
| Zdroj: | Journal of Neurology. 268:1485-1490 |
| ISSN: | 1432-1459 0340-5354 |
| DOI: | 10.1007/s00415-020-10318-3 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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