title: A smooth transition protocol for patients with multifocal motor neuropathy going from intravenous to subcutaneous immunoglobulin therapy: an open-label proof-of-concept study.
abstract: Intravenous immunoglobulin (IVIG) is the first-line therapy for multifocal motor neuropathy (MMN). This open-label multi-centre study (NCT00701662) assessed the efficacy, safety, and convenience of subcutaneous immunoglobulin (SCIG) in patients with MMN over 6 months, as an alternative to IVIG. Eight MMN patients (42-66 years), on stable IVIG dosing, received weekly SCIG at doses equivalent to previous IVIG using a "smooth transition protocol". Primary efficacy endpoint was the change from baseline to week 24 in muscle strength. Disability, motor function, and health-related quality of life (HRQL) endpoints were also assessed. One patient deteriorated despite dose increase and was withdrawn. Muscle strength, disability, motor function, and health status were unchanged in all seven study completers who rated home treatment as extremely good. Four experienced 18 adverse events, of which only two were moderate. This study suggests that MMN patients with stable clinical course on regular IVIG can be switched to SCIG at the same monthly dose without deterioration and with a sustained overall improvement in HRQL.
authors.affiliation: Department of Clinical Immunology, John Radcliffe Hospital, Headington, Oxford, UK. siraj.misbah@orh.nhs.uk
authors.forename: Siraj A
authors.initials: SA
authors.lastname: Misbah
authors.forename: Andreas
authors.initials: A
authors.lastname: Baumann
authors.forename: Raffaella
authors.initials: R
authors.lastname: Fazio
authors.forename: Patrizia
authors.initials: P
authors.lastname: Dacci
authors.forename: Dirk S
authors.initials: DS
authors.lastname: Schmidt
authors.forename: Janet
authors.initials: J
authors.lastname: Burton
authors.forename: Matthias
authors.initials: M
authors.lastname: Sturzenegger
mesh_terms: D000328:Adult; D000368:Aged; D003711:Demyelinating Diseases / Q000188:drug therapy*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007136:Immunoglobulins / Q000008:administration & dosage*; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007155:Immunologic Factors / Q000008:administration & dosage*; D055104:Infusions, Subcutaneous; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000187:drug effects; D011115:Polyneuropathies / Q000188:drug therapy*; D011788:Quality of Life
chemical_list: D007136:Immunoglobulins; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors