title: High-dose Ig VENA is well tolerated and efficacious in patients with multifocal motor neuropathy.
abstract: Multifocal motor neuropathy (MMN) is a rare, chronic, motor neuropathy that progressively impairs physical functioning and quality of life. Randomised controlled trials have shown that high-dose intravenous immunoglobulin (IVIg) is superior to placebo in improving muscle strength and disability, but many patients require periodic infusions to maintain long-term improvement. This observational, multicentre, retrospective study investigated the efficacy and tolerability of human normal immunoglobulin (Ig VENA) at high intravenous infusion rates in 20 MMN patients (14 male, 6 female). Thirty days after the first infusion, there was an improvement of at least 1 point in two muscles compared to baseline on the Medical Research Council (MRC) scale and of 1 point in the ONLS (Overall Neuropathy Limitation Scale) scale in 15 patients (75%) and 10 patients (50%), respectively; 45% improved on both scales. At 6 months, 100% of 12 patients had improved on the MRC and 79% of 14 patients had improved on the ONLS scale; 83% improved on both scales. All reported adverse drug reactions (ADR) were mild, transient and possibly related to the study drug. Four patients (20%) reported ADRs, three reported headache and one fever. There were no serious or unexpected ADRs. By confirming that high-dose Ig VENA is efficacious and well tolerated, this study adds to the evidence base for IVIg in MMN and potentially increases clinicians' and patients' choice of therapy.
authors.affiliation: Department of Medical Biotechnology and Translational Medicine (BIOMETRA), Neuromuscular and Neuroimmunology Service, Humanitas Clinical and Research Centre, Milan University, Rozzano, Milan, Italy. eduardo.nobile@unimi.it.|Department of Medical Biotechnology and Translational Medicine, Neuromuscular and Neuroimmunology Service, Humanitas Clinical and Research Institute, Milan University, Via Manzoni 56, 20089, Rozzano, Milan, Italy. eduardo.nobile@unimi.it.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Nobile-Orazio
authors.affiliation: Neurology 2, Neuroscience Department, Turin University, Turin, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Cocito
authors.affiliation: Department of Neurosciences, Padua University, Padua, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Briani
authors.affiliation: IRCCS Neurological Sciences, Bellaria Hospital, Bologna, Italy.
authors.forename: Rosaria
authors.initials: R
authors.lastname: Plasmati
authors.affiliation: Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, Genoa University, Genoa, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Schenone
authors.affiliation: Department of Medical Biotechnology and Translational Medicine (BIOMETRA), Neuromuscular and Neuroimmunology Service, Humanitas Clinical and Research Centre, Milan University, Rozzano, Milan, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Gallia
authors.affiliation: Kedrion Biopharma, Medical Affairs, Castelvecchio Pascoli, Lucca, Italy.
authors.forename: Ivan
authors.initials: I
authors.lastname: Marjanovic
authors.affiliation: Kedrion Biopharma, Medical Affairs, Castelvecchio Pascoli, Lucca, Italy.
authors.forename: Anna Lotti
authors.initials: AL
authors.lastname: Suffredini
mesh_terms: D000328:Adult; D000368:Aged; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007155:Immunologic Factors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011115:Polyneuropathies / Q000188:drug therapy*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors
keywords: Efficacy; High dose; Ig VENA; Immunoglobulin therapy; Multifocal motor neuropathy; Tolerability