Intravenous immunoglobulin (IVIG) is an established
therapy for a number of neuroimmune disorders, including
Guillain-Barré syndrome and chronic inflammatory demyelinating
polyneuropathy. IVIG exerts a number of effects that may be
beneficial in multiple sclerosis (MS): reduction of
inflammation, inhibition of macrophages, and promotion of
remyelination. Four double-blind trials have been performed of
IVIG in relapsing-remitting MS. A meta-analysis of the four
trials has shown that IVIG reduces the relapse rate, new MRI
lesions, and disease progression. IVIG does not seem to be of
any benefit in chronic visual or motor symptoms in MS. In
secondary progressive MS, IVIG has not shown effect on disease
progression, relapses or new MRI lesions. In conclusion, IVIG is
an alternative second-line treatment to approved therapies in
relapsing-remitting MS, but the ideal dosage of IVIG still needs
to be determined.