ARCHIVED FILE 11/98

MEDLINE ABSTRACTS on IgG

Combined immunoglobulin and azathioprine in multiple sclerosis.
Kalanie H, Tabatabai SS
Eur Neurol 1998 39:3 178-81


Abstract
In an attempt to prevent exacerbations of multiple sclerosis, immunoglobulin therapy was combined with azathioprine (AZA). Intravenous immunoglobulin (i.v.IG) 2 g/kg was given in divided doses over 3 consecutive days followed by monthly booster doses (0.2 g/kg) for 3 years to 38 patients with relapsing-remitting multiple sclerosis (MS). In the 34 patients who completed the trial, the relapse rate decreased (from 1.7 relapses per year to 0 during the 3-year trial period). The Kurtzke Expanded Disability Status Scale decreased from 3.4 +/- 0.72 to 3.0 +/- 0.70. The results suggest that combined i.v.IG and AZA suppress the ongoing pathologic process in relapsing-remitting MS.


MeSH
Adolescence ; Adult ; Azathioprine ; Female ; Human ; Immunization, Passive
; Immunoglobulins, Intravenous ;
Immunosuppressive Agents ; Male ; Middle Age ; Multiple Sclerosis ; Nervous
System Diseases ; Treatment Outcome ;


Author Address
Department of Neurology, Mehr Hospital, Shahid Beheshti University of
Medical Sciences, Tehran, Iran.

Intravenous immunoglobulins in therapy of intermittent multiple sclerosis.
An update] Fazekas F, Strasser-Fuchs S, Hartung HP
Nervenarzt 1998 Apr 69:4 361-5


Abstract
Experimental studies and open clinical trials have suggested intravenous immunoglobulin (i.v.Ig) as a potentially effective treatment of multiple sclerosis (MS). The Austrian Immunoglobulin in Multiple Sclerosis (AIMS) study tested this assumption by examining 148
patients with relapsing-remitting MS in a randomized, double-blind, placebo controlled fashion (75 i.v.Ig, 73 placebo). Monthly administration of i.v.Ig in a dosage of 0.15-0.20 g/kg over a period of 2 years slowed the progression of or even reversed disability as evident in a total of 24% of patients and almost halved the number of relapses in comparison to placebo treatment. Therapeutic efficacy was noted within the first 6 months of treatment and was not correlated to the severity of disability (mild neurological signs without disability to ambulatory with assistance) at study entry. Overall the reported for beta-interferon and copolymer 1. Further ongoing studies will have to clarify the future role of i.v.Ig in the treatment of MS, in particular in the progressive forms of the disease.


MeSH
Austria ; Disability Evaluation ; Double-Blind Method ; English Abstract ;
Human ; Immunization, Passive ; Multiple Sclerosis ;
Neurologic Examination ; Recurrence ;

Author Address
Universitätsklinik für Neurologie, Karl-Franzens Universität Graz.

Intravenous immunoglobulin G reduces MRI activity in relapsing multiple
sclerosis.
Sorensen PS, Wanscher B, Jensen CV, Schreiber K, Blinkenberg M, Ravnborg M,
Kirsmeier H, Larsen VA,
Lee ML
Neurology 1998 May 50:5 1273-81


Abstract
We wanted to assess whether intravenous immunoglobulin G (IVIG) decreases disease activity on MRI in relapsing MS. Previous trials of IVIG in relapsing-remitting MS demonstrated a reduction of acute relapses, but these studies did not include MRI. We treated 26 patients in a randomized, double-blind, crossover study of IVIG 1 g/kg daily or placebo on 2 consecutive days every month during two 6-month treatment periods. The primary end point was the number of gadolinium-enhancing lesions on monthly serial MRI. Secondary
efficacy variables were the occurrence of exacerbations, clinical neurologic ratings, total MS lesion load on T2-weighted MRI, and multimodal evoked potentials. Eighteen patients completed the entire trial; eight patients did not. Twenty-one patients completed the first treatment period and at least two MRI examinations in the second treatment period and were included in the intention-to-treat analysis. On serial MRI, we observed fewer enhancing lesions per patient per scan during IVIG treatment (median, 0.4; range, 0 to 9.3) than
during placebo treatment (median, 1.3; range, 0.2 to 25.7; p = 0.03). During IVIG treatment, 15 patients were exacerbation free compared with only 7 on placebo (p = 0.02). The total number of exacerbations in the IVIG period was 11 and in the placebo period, 19 (not significant). None of the remaining secondary efficacy measures were significantly different between the two treatment periods. The number of adverse events, in particular eczema, was significantly higher during IVIG therapy than during placebo treatment. These results suggest that IVIG treatment is beneficial to patients with relapsing MS.


MeSH
Adolescence ; Adult ; Cross-Over Studies ; Disease Progression ;
Double-Blind Method ; Evoked Potentials ; Female ; Gadolinium ;
Human ; Immunoglobulins, Intravenous ; Magnetic Resonance Imaging ; Male ;
Middle Age ; Multiple Sclerosis ;
Recurrence ; Support, Non-U.S. Gov't ;