PMID- 18567877
OWN - NLM
STAT- MEDLINE
DCOM- 20080908
LR  - 20080623
IS  - 0077-8923 (Print)
IS  - 0077-8923 (Linking)
VI  - 1132
DP  - 2008
TI  - IVIG treatment for myasthenia gravis: effectiveness, limitations, and novel 
      therapeutic strategies.
PG  - 264-70
LID - 10.1196/annals.1405.038 [doi]
AB  - Acquired myasthenia gravis (MG) is an autoimmune disorder treated with 
      cholinesterase inhibitors and a number of immunotherapies. Intravenous 
      immunoglobulin (IVIG) is an expensive and commonly used immunotherapy for 
      patients with an exacerbation of MG, but its effectiveness has only recently been 
      demonstrated in a randomized clinical trial. This paper describes the study 
      design, results, and limitations of a double-blind, randomized, 
      placebo-controlled trial designed to definitively determine if IVIG benefits 
      patients with MG who present with worsening weakness. Fifty-one patients with 
      worsening weakness due to MG were randomized to receive either 2 g/kg of IVIG 
      over 2 days or an equivalent volume of placebo (5% dextrose in water). The 
      Quantitative MG Score (QMG Score) for Disease Severity, a validated clinical 
      composite scale and the primary outcome measure in the study, was calculated by a 
      masked observer 14 and 28 days after treatment. Patients treated with IVIG 
      demonstrated a significant improvement in QMG Score for Disease Severity at day 
      14 and the response persisted at day 28. The largest clinical improvement 
      occurred in patients with more severe disease. IVIG was well tolerated with no 
      significant side effects observed. Given the observed efficacy and safety of IVIG 
      demonstrated in this trial, future studies are necessary to determine if there is 
      a role for interval IVIG treatments in chronic MG.
FAU - Zinman, Lorne
AU  - Zinman L
AD  - Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada. 
      lorne.zinman@sunnybrook.ca
FAU - Bril, Vera
AU  - Bril V
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Ann N Y Acad Sci
JT  - Annals of the New York Academy of Sciences
JID - 7506858
RN  - 0 (Immunoglobulins, Intravenous)
SB  - IM
MH  - Female
MH  - Humans
MH  - Immunoglobulins, Intravenous/*therapeutic use
MH  - Immunotherapy
MH  - Male
MH  - Middle Aged
MH  - Myasthenia Gravis/*immunology/pathology/*therapy
MH  - *Randomized Controlled Trials as Topic
EDAT- 2008/06/24 09:00
MHDA- 2008/09/09 09:00
CRDT- 2008/06/24 09:00
PHST- 2008/06/24 09:00 [pubmed]
PHST- 2008/09/09 09:00 [medline]
PHST- 2008/06/24 09:00 [entrez]
AID - 1132/1/264 [pii]
AID - 10.1196/annals.1405.038 [doi]
PST - ppublish
SO  - Ann N Y Acad Sci. 2008;1132:264-70. doi: 10.1196/annals.1405.038.