Subcutaneous versus intravenous immunoglobulin for chronic autoimmune neuropathies: A meta-analysis

Muscle Nerve. 2017 Jun;55(6):802-809. doi: 10.1002/mus.25409. Epub 2017 Feb 9.

Abstract

Introduction: High-dose intravenous immunoglobulin (IVIg) is an evidence-based treatment for multifocal motor neuropathy (MMN) and chronic inflammatory demyelinating polyneuropathy (CIDP). Recently, subcutaneous immunoglobulin (SC-Ig) has received increasing attention.

Methods: We performed a meta-analysis of reports of efficacy and safety of SC-Ig versus IVIg for inflammatory demyelinating polyneuropathies.

Results: A total of 8 studies comprising 138 patients (50 with MMN and 88 with chronic CIDP) were included in the meta-analysis. There were no significant differences in muscle strength outcomes in MMN and CIDP with Sc-Ig (MMN: effect size [ES] = 0.65, 95% confidence interval [CI] = -0.31-1.61; CIDP: ES = 0.84, 95% CI = -0.01-1.69). Additionally SC-Ig had a 28% reduction in relative risk (RR) of moderate and/or systemic adverse effects (95% CI = 0.11-0.76).

Conclusions: The efficacy of SC-Ig is similar to IVIg for CIDP and MMN and has a significant safety profile. Muscle Nerve 55: 802-809, 2017.

Keywords: CIDP; MMN; chronic inflammatory demyelinating polyneuropathy; immunoglobulin therapy; meta-analysis; multifocal motor neuropathy.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Administration, Cutaneous*
  • Databases, Bibliographic / statistics & numerical data
  • Female
  • Humans
  • Immunoglobulins / administration & dosage*
  • Immunoglobulins, Intravenous / therapeutic use*
  • Male
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / drug therapy*

Substances

  • Immunoglobulins
  • Immunoglobulins, Intravenous