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

Neurol Sci. 2017 May;38(5):899-902. doi: 10.1007/s10072-017-2826-8. Epub 2017 Jan 31.


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.

Keywords: Efficacy; High dose; Ig VENA; Immunoglobulin therapy; Multifocal motor neuropathy; Tolerability.

MeSH terms

  • Adult
  • Aged
  • Disability Evaluation
  • Female
  • Follow-Up Studies
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use*
  • Immunologic Factors / therapeutic use*
  • Male
  • Middle Aged
  • Polyneuropathies / drug therapy*
  • Retrospective Studies
  • Severity of Illness Index
  • Treatment Outcome


  • Immunoglobulins, Intravenous
  • Immunologic Factors