[Intravenous immunoglobulins in multiple sclerosis. An update]

In MS patients with contraindications, intolerance, or failure of established immunomodulatory drugs, intravenous immunoglobulins (IVIG) are increasingly being administered. Several clinical studies recently showed that IVIG are generally safe, well tolerated and only occasionally have serious side effects. While some studies indicated beneficial effects from IVIG in relapsing-remitting MS, the recently published PRIVIG study failed to show any clinical benefit. Although pregnancy and the post-partum period appear to be interesting potential indications for IVIG, since under those conditions all other immunomodulatory drugs except for corticosteroids are not indicated, there are no data from adequate studies to support the use of IVIG in this patient group. For other indications in MS patients, study results are either negative or lacking. Overall IVIG may be considered a safe second-line compound in patients with relapsing-remitting MS. However, efficacy, long-term consequences, and optimal dosage of IVIG have not been unequivocally ascertained as yet.