[Intravenous immunoglobulin in multiple sclerosis]

Intravenous immunoglobulin(IVIg) is a immunomodulating therapy to administer a relatively high dose of human immunoglobulins to a number of autoimmune diseases. Clinical trials of IVIg for neurological disorders including autoimmune peripheral neuropathy were carried out since the later of 1980's, and the efficacy of IVIg for such diseases was proved. In recent years the effectiveness of IVIg for multiple sclerosis(MS) has been reported in several randomized controlled trials(RCTs). MS patients in the trials were given immunoglobulin or placebo every month or two months for more than half a year. IVIg in particular is beneficial in prevention a recurrence of relapsing remitting MS and in improvement of MRI findings in a part of RCTs. However, IVIg does not recognize the distinct effectiveness in progression of secondary progressive MS yet. Some problems, for example, optimal dose or dosage frequency are unsolved. Generally a adverse effect of IVIg in MS patient is slightness and the continuation treatment of IVIg is tolerate for most patients. Now, in Europe where a clinical trial goes ahead, IVIg might be considered the therapy for MS when a already established treatment for MS such as interferon--beta is not effective or not be able to use. On the other hand, unfortunately the effectiveness of IVIg for MS could not be recognized by RCT executed in Japan.