Immunoglobulin treatment in post-polio syndrome: Identification of responders and non-responders.
OBJECTIVE
To define and characterize responders and non-responders in a group of 124 patients with post-polio syndrome who received a single treatment with intravenous immunoglobulin.


METHODS
Open trial, prospective follow-up study.


METHODS
Clinical examination and data from medical records. Short Form 36 (SF-36), Physical Activity Scale for the Elderly (PASE) and visual analogue scale (VAS) measured quality of life, physical activity and intensity of pain, respectively. Data were obtained before treatment and at 6-month follow-up.


RESULTS
Two responder groups were identified with the outcome SF-36 Vitality and 3 with Bodily pain, respectively. Forty-five percent were positive-responders, identified before treatment by reduced physical function, muscle atrophy in the lower extremities, higher levels of fatigue and pain, and a VAS pain score above 20. Negative-responders were identified by good physical function and mental health, lesser muscle atrophy in the lower extremities, and low levels of fatigue and pain.


CONCLUSIONS
Intravenous immunoglobulin is a biological intervention, and therefore it is important to be able to identify responders and non-responders. In order to maximize a positive outcome it is suggested that patients with a high level of fatigue and/or pain and reduced physical function are selected.
Department of Rehabilitation Medicine, Danderyd University Hospital, Building 39, 3rd floor, SE-182 88 Stockholm, Sweden. gunilla.ostlund@ki.se, gunilla.ostlund@ds.se.
Gunilla
G
Östlund
Lisbet
L
Broman
Lars
L
Werhagen
Kristian
K
Borg
D061605:Administration, Intravenous; D000368:Aged; D005221:Fatigue / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D010146:Pain / Q000188:drug therapy*; D016262:Postpoliomyelitis Syndrome / Q000188:drug therapy*; D011446:Prospective Studies; D011788:Quality of Life
D016756:Immunoglobulins, Intravenous