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Consensus statement: The use of intravenous immunoglobulin in the treatment of neuromuscular conditions report of the aanem AD HOC committee
Author(s) -
Donofrio Peter D.,
Berger Alan,
Brannagan Thomas H.,
Bromberg Mark B.,
Howard James F.,
Latov Normal,
Quick Adam,
Tandan Rup
Publication year - 2009
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.21433
Subject(s) - multifocal motor neuropathy , medicine , chronic inflammatory demyelinating polyneuropathy , dermatomyositis , polymyositis , myasthenia gravis , context (archaeology) , neuromuscular disease , gabapentin , inclusion body myositis , physical therapy , mismatch negativity , immunology , alternative medicine , antibody , disease , pathology , paleontology , electroencephalography , psychiatry , biology
Intravenous immunoglobulin (IVIG) is a therapeutic biologic agent that has been prescribed for over two decades to treat various neuromuscular conditions. Most of the treatments are given off‐label, as little evidence from large randomized trials exists to support its use. Recently, IGIV‐C has received an indication for the treatment of chronic inflammatory demyelinating polyneuropathy (CIDP). Because of the lack of evidence, an ad hoc committee of the AANEM was convened to draft a consensus statement on the rational use of IVIG for neuromuscular disorders. Recommendations were categorized as Class I–IV based on the strength of the medical literature. Class I evidence exists to support the prescription of IVIG to treat patients with Guillain–Barré syndrome (GBS), CIDP, multifocal motor neuropathy, refractory exacerbations of myasthenia gravis, Lambert–Eaton syndrome, dermatomyositis, and stiff person syndrome. Treatment of Fisher syndrome, polymyositis, and certain presumed autoimmune neuromuscular disorders is supported only by Class IV studies, whereas there is no convincing data to substantiate the treatment of inclusion body myopathy (IBM), idiopathic neuropathies, brachial plexopathy, or diabetic amyotrophy using IVIG. Treatment with IVIG must be administered in the context of its known adverse effects. There is little evidence to advise the clinician on the proper dosing of IVIG and duration of therapy. Muscle Nerve, 2009