Guillain-Barré syndrome (GBS),
chronic inflammatory demyelinating polyradiculoneuropathy (
CIDP) and multifocal motor neuropathy (MMN) are the major immune neuropathies. Although a detailed understanding of the pathogenesis of these conditions is not yet available, the multiple effects of
IVIg on the immune and inflammatory process recommend it as an agent worthy of investigation in these diseases. Following recent research,
IVIg is now recommended as a first-line treatment option for moderate or severe GBS to be administered within two weeks of disease onset. With regard to
CIDP, a Cochrane review demonstrated significant short-term improvements in disability and impairment with
IVIg. The
ICE (IGIV
CIDP Efficacy trial) study group undertook the largest ever trial of
IVIg for
CIDP, which demonstrated for the first time the long-term efficacy of
IVIg. The results of this
ICE trial demonstrated the efficacy of
IVIg in
CIDP, with a significantly higher response rate versus placebo after 24 weeks of treatment (P = 0.0002). Furthermore, long-term maintenance with
IVIg also significantly reduced the rate of relapse (P < 0.011). On the basis of available data,
IVIg can be recommended as a first-line treatment option for GBS and
CIDP. For MMN, although the evidence for
IVIg is limited, there is no evidence to recommend other treatments.