Skip to main content

Advertisement

SpringerLink
Log in

High-dose Ig VENA is well tolerated and efficacious in patients with multifocal motor neuropathy

  • Brief Communication
  • Published:
Neurological Sciences Aims and scope Submit manuscript

Abstract

Multifocal motor neuropathy (MMN) is a rare, chronic, motor neuropathy that progressively impairs physical functioning and quality of life. Randomised controlled trials have shown that high-dose intravenous immunoglobulin (IVIg) is superior to placebo in improving muscle strength and disability, but many patients require periodic infusions to maintain long-term improvement. This observational, multicentre, retrospective study investigated the efficacy and tolerability of human normal immunoglobulin (Ig VENA) at high intravenous infusion rates in 20 MMN patients (14 male, 6 female). Thirty days after the first infusion, there was an improvement of at least 1 point in two muscles compared to baseline on the Medical Research Council (MRC) scale and of 1 point in the ONLS (Overall Neuropathy Limitation Scale) scale in 15 patients (75%) and 10 patients (50%), respectively; 45% improved on both scales. At 6 months, 100% of 12 patients had improved on the MRC and 79% of 14 patients had improved on the ONLS scale; 83% improved on both scales. All reported adverse drug reactions (ADR) were mild, transient and possibly related to the study drug. Four patients (20%) reported ADRs, three reported headache and one fever. There were no serious or unexpected ADRs. By confirming that high-dose Ig VENA is efficacious and well tolerated, this study adds to the evidence base for IVIg in MMN and potentially increases clinicians’ and patients’ choice of therapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

References

  1. Joint Task Force of the EFNS and the PNS (2006) European Federation of Neurological Societies/Peripheral Nerve Society guidelines on management of multifocal motor neuropathy. Eur J Neurol 13:802–808

    Article  Google Scholar 

  2. Nobile-Orazio E, Cappellari A, Priori A (2006) Multifocal motor neuropathy: current concepts and controversies. Muscle Nerve 31:663–680

    Article  Google Scholar 

  3. Joint Task Force of the EFNS and the PNS (2010) European Federation of Neurological Societies/Peripheral Nerve Society guideline on management of multifocal motor neuropathy. Report of a joint task force of the European Federation of Neurological Societies and the Peripheral Nerve Society–first revision. J Peripher Nerv Syst 15:295–301

    Article  Google Scholar 

  4. Willison HJ, Yuki N (2002) Peripheral neuropathies and anti-glycolipid antibodies. Brain 125:2591–2625

    Article  PubMed  Google Scholar 

  5. Van Schaik IN, van den Berg LH, de Haan R, Vermeulen M (2005) Intravenous immunoglobulin for multifocal motor neuropathy. Cochrane Database Syst Rev 2005:CD004429

    Google Scholar 

  6. Hahn AF, Beydoun SR, Lawson VH, IVIG in MMN Study Team, Oh M, Empson VG et al (2013) A controlled trial of intravenous immunoglobulin in multifocal motor neuropathy. J Peripher Nerv Syst 18:321–330

  7. Leger J, Viala K, Cancalon F, Maisonobe T, Gruwez B, Waegemans T et al (2008) Intravenous immunoglobulin as short- and long-term therapy of multifocal motor neuropathy: a retrospective study of response to IVIg and of its predictive criteria in 40 patients. J Neurol Neurosurg Pyschiatry 79:93–96

    Article  Google Scholar 

  8. Lawson V, Arnold W (2014) Multifocal motor neuropathy: a review of pathogenesis, diagnosis and treatment. Neuropsychiatr Dis Treat 10:567–576

    PubMed  PubMed Central  Google Scholar 

  9. Piepers S, Van den Berg-Vos R, Van der Pol W, Franssen H, Wokke J, Van den Berg L (2007) Mycophenolate mofetil as adjunctive therapy for MMN patients: a randomized, controlled trial. Brain 130(Pt 8):2004–2010

    Article  PubMed  Google Scholar 

  10. Sewell WA, Kerr J, Behr-Gross ME, Peter HH, Kreuth Ig Working Group (2014) European consensus proposal for immunoglobulin therapies. Eur J Immunol 44:2207–2214

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

This research was conducted with the financial support of Kedrion Biopharma, Castelvecchio Pascoli—Lucca, Italy. We thank Sue Lyon for preparing an initial English-language draft of this article. Collaborators: (2) Ilaria Paolasso—Turin, Italy. (3) Marta Campagnolo—Padua, Italy. (4) Francesca Pastorelli—Bologna, Italy. (5) Martina Garnero, Marina Grandis & Giulia Ursino—Genoa, Italy.

Author information

Authors and Affiliations

  1. Department of Medical Biotechnology and Translational Medicine (BIOMETRA), Neuromuscular and Neuroimmunology Service, Humanitas Clinical and Research Centre, Milan University, Rozzano, Milan, Italy

    Eduardo Nobile-Orazio & Francesca Gallia

  2. Neurology 2, Neuroscience Department, Turin University, Turin, Italy

    Dario Cocito

  3. Department of Neurosciences, Padua University, Padua, Italy

    Chiara Briani

  4. IRCCS Neurological Sciences, Bellaria Hospital, Bologna, Italy

    Rosaria Plasmati

  5. Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, Genoa University, Genoa, Italy

    Angelo Schenone

  6. Kedrion Biopharma, Medical Affairs, Castelvecchio Pascoli, Lucca, Italy

    Ivan Marjanovic & Anna Lotti Suffredini

  7. Department of Medical Biotechnology and Translational Medicine, Neuromuscular and Neuroimmunology Service, Humanitas Clinical and Research Institute, Milan University, Via Manzoni 56, 20089, Rozzano, Milan, Italy

    Eduardo Nobile-Orazio

Authors
  1. Eduardo Nobile-Orazio
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Dario Cocito
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Chiara Briani
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Rosaria Plasmati
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Angelo Schenone
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Francesca Gallia
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ivan Marjanovic
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Anna Lotti Suffredini
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Eduardo Nobile-Orazio.

Ethics declarations

Conflict of interest

Eduardo Nobile-Orazio reports personal compensation for serving on the Steering Committee or Advisory Board of: Baxter, Italy; CSL Behring, Italy; Kedrion, Italy; LFB, France; and Novartis, Switzerland. He has received honoraria for lecturing from Baxter, CSL Behring, and Kedrion and travel supports for Scientific Meetings from CSL Behring and Kedrion. All compensations and supports are outside the submitted work. Dario Cocito received honoraria for lecturing CSL Behring, and Kedrion and travel supports for Scientific Meetings from CSL Behring and Kedrion. All compensations and supports are outside the submitted work. Chiara Briani, Rosaria Plasmati, Angelo Schenone received travel support for scientific meetings from Kedrion. Francesca Gallia received travel support for scientific meetings from CSL Behring and Kedrion. Ivan Marjanovic and Anna Lotti Suffredini are employees of Kedrion Biopharma, Castelvecchio Pascoli—Lucca, Italy.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nobile-Orazio, E., Cocito, D., Briani, C. et al. High-dose Ig VENA is well tolerated and efficacious in patients with multifocal motor neuropathy. Neurol Sci 38, 899–902 (2017). https://doi.org/10.1007/s10072-017-2826-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10072-017-2826-8

Keywords

Search

Navigation