[Intravenous immunoglobulins in multiple sclerosis. An update]

Area of Science:

• Neurology
• Immunology
• Pharmacology

Context:

• Multiple Sclerosis (MS) management often requires alternative therapies when standard treatments fail or are contraindicated.
• Intravenous immunoglobulins (IVIG) are increasingly considered for MS patients, particularly those with relapsing-remitting MS (RRMS).
• Existing immunomodulatory drugs may not be suitable for all MS patients, especially during pregnancy and postpartum.

Purpose:

• To evaluate the safety and efficacy of intravenous immunoglobulins (IVIG) as a treatment option for Multiple Sclerosis (MS).
• To review current clinical evidence supporting IVIG use in various MS patient populations.
• To identify gaps in knowledge regarding IVIG's long-term effects and optimal dosing in MS.

Summary:

• Clinical studies suggest IVIG is generally safe and well-tolerated in MS patients, with rare serious side effects.
• While some research indicates potential benefits of IVIG for relapsing-remitting MS (RRMS), recent studies like PRIVIG have not demonstrated clinical efficacy.
• Limited data exists for IVIG use in MS during pregnancy and postpartum, and efficacy for other MS indications is largely unproven or negative.

Impact:

• IVIG may serve as a viable second-line treatment for RRMS patients unresponsive to other therapies.
• Further research is crucial to establish definitive efficacy, long-term outcomes, and appropriate dosing strategies for IVIG in MS.
• The findings highlight the need for more robust clinical trials to support IVIG's role in comprehensive MS care.