A to Z of MS
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A to Z of MS Intravenous immunoglobulin (IVIg)
Immunoglobulins are sometimes used as a disease modifying treatment for multiple sclerosis. Immunoglobulins are obtained from the blood plasma of screened healthy human donors. The NICE Guideline states that this should be used only in specific circumstances by experienced practitioners where the treatment and possible side effects have been fully discussed.
In 2007 guidelines published by the Department of Health did not recommend the use of intravenous immunoglobulin for multiple sclerosis.
How intravenous immunoglobulin works
The way that immunoglobulins act in MS is not fully understood but they are thought to exert a multitude of effects on the immune system that reduce inflammation and demyelination. Studies have shown that this results in reduction of relapse rate in people with relapsing remitting MS by about a third (similar to that of the beta interferon drugs and glatiramer acetate).
How is intravenous immunoglobulin given?
This is given by intravenous infusion once a month but a dose over five days may be given at the start of the therapy.
Side effects and contraindications
The most commonly reported side effects are headache and nausea and chills, which can be controlled by slowing down the rate of infusion.
References
Sorensen PS, et al.
A double-blind cross-over trial of intravenous immunoglobulin G in multiple sclerosis: Preliminary results.
Multiple Sclerosis 1997;3:145-148.
abstract
Humle Jorgensen S, Sorensen PS.
Intravenous immunoglobulin treatment of multiple sclerosis and its animal model, experimental autoimmune encephalomyelitis.
Journal of Neurological Sciences 2005;233(1-2):61-65.
abstract
Department of Health.
Clinical guidelines for the use of intravenous immunoglobulin.
London: DH; 2007.
Download from the Department of Health website (pdf 2.03Mb)