PMID- 12453069
OWN - NLM
STAT- MEDLINE
DCOM- 20030210
LR  - 20191106
IS  - 1351-5101 (Print)
IS  - 1351-5101 (Linking)
VI  - 9
IP  - 6
DP  - 2002 Nov
TI  - Intravenous immunoglobulin G for the treatment of relapsing-remitting multiple 
      sclerosis: a meta-analysis.
PG  - 557-63
AB  - Intravenous immunoglobulin (IVIG) has several effects on the immune system that 
      could have a beneficial influence on disease processes in multiple sclerosis 
      (MS). Four double-blind trials in relapsing-remitting MS have demonstrated that 
      IVIG may reduce the relapse rate, progression and the number of 
      gadolinium-enhancing lesions. However, these trials were smaller than the pivotal 
      trials of interferon-beta and glatiramer acetate, and therefore, we performed a 
      meta-analysis of the four trials in order to provide an overall assessment of the 
      benefits of IVIG in relapsing-remitting multiple sclerosis in comparison with 
      other drugs currently available for treatment of disease activity in MS. The 
      meta-analysis showed a significant beneficial effect on the annual relapse rate 
      (effect size -0.5; P = 0.00003), on the proportion of relapse-free patients (0.29 
      difference; P = 2.1 x 10(-8)), change in Expanded Disability Status Scale (EDSS) 
      score (effect size: 0.25; P = 0.04), and a trend towards a reduction in the 
      proportion of patients who deteriorated (P = 0.03). Each single study in the 
      meta-analysis had its weaknesses, but all studies were positive regarding their 
      primary end-point, and the results yield concordant evidence for reduction of 
      relapse rate and progression. The ideal dosage of IVIG for treating MS needs 
      still to be determined. In conclusion, IVIG may be a valuable alternative for 
      treatment of relapsing-remitting MS, but can presently not be considered as a 
      first-line treatment. IVIG could be considered in patients who do not tolerate or 
      are unwilling to take the approved injectable medications, but additional studies 
      are needed to establish the role of IVIG in the management of multiple sclerosis.
FAU - Sorensen, P S
AU  - Sorensen PS
AD  - MS Research Unit, Department of Neurology, Copenhagen University Hospital, 
      Rigshospitalet, Copenhagen, Denmark. pss@rh.dk
FAU - Fazekas, F
AU  - Fazekas F
FAU - Lee, M
AU  - Lee M
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PL  - England
TA  - Eur J Neurol
JT  - European journal of neurology
JID - 9506311
RN  - 0 (Immunoglobulins, Intravenous)
SB  - IM
MH  - Disabled Persons
MH  - Humans
MH  - Immunoglobulins, Intravenous/*therapeutic use
MH  - Multiple Sclerosis, Relapsing-Remitting/*drug therapy/physiopathology
MH  - Randomized Controlled Trials as Topic
MH  - Recurrence
EDAT- 2002/11/28 04:00
MHDA- 2003/02/11 04:00
CRDT- 2002/11/28 04:00
PHST- 2002/11/28 04:00 [pubmed]
PHST- 2003/02/11 04:00 [medline]
PHST- 2002/11/28 04:00 [entrez]
AID - 501 [pii]
AID - 10.1046/j.1468-1331.2002.00501.x [doi]
PST - ppublish
SO  - Eur J Neurol. 2002 Nov;9(6):557-63. doi: 10.1046/j.1468-1331.2002.00501.x.