Abstract | OBJECTIVES: METHODS: A 12 month multicentre, prospective, randomised, open clinical trial was carried out comparing intravenous immunoglobulin ( IVIg; 2g/kg and then 1 g/kg every three weeks) and recombinant interferon-alpha (IFN-alpha; 3 MU/m2 subcutaneously three times weekly). The main end point was a clinical neuropathy disability score (CNDS) after six months of treatment. Twenty patients were enrolled; 10 were assigned to IVIg and 10 to IFN-alpha. RESULTS: At six months, one out of 10 patients treated with IVIg had a CNDS improvement of more than 20% whereas eight out of 10 patients treated with IFN-alpha had such an improvement (P=0.005). The mean CNDS worsened by 2.3 (SD 7.6) (8%) in the IVIg group whereas it improved by 7.5 (SD 11.1) (31%) in the IFN-alpha group (P=0.02). This improvement persisted after 12 months and was mainly related to an improvement of the sensory component (P=0.02) whereas the motor component was unchanged (P=0.39). Electrophysiological data did not show improvement of motor nerve conduction velocities whereas sensory nerve conduction velocities improved in the upper limbs. A decrease in the level of the monoclonal IgM was seen in two patients treated with IFN-alpha. At the end of the treatment, antibody activity to MAG was still detected in the serum of all patients. CONCLUSION:
IVIg, as used in this study, did not improve patients with polyneuropathy and monoclonal IgM. By contrast, although its mechanism of action remains to be fully elucidated, IFN-alpha was effective in eight out of 10 patients at six months.
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Authors | X Mariette, C Chastang, P Clavelou, J P Louboutin, J M Leger, J C Brouet |
Journal | Journal of neurology, neurosurgery, and psychiatry
(J Neurol Neurosurg Psychiatry)
Vol. 63
Issue 1
Pg. 28-34
(Jul 1997)
ISSN: 0022-3050 [Print] England |
PMID | 9221964
(Publication Type: Clinical Trial, Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Immunoglobulin M
- Immunoglobulins, Intravenous
- Interferon Type I
- Myelin-Associated Glycoprotein
- Recombinant Proteins
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Topics |
- Adult
- Aged
- Electrophysiology
- Female
- Humans
- Immunoglobulin M
(immunology)
- Immunoglobulins, Intravenous
(therapeutic use)
- Interferon Type I
(therapeutic use)
- Male
- Middle Aged
- Myelin-Associated Glycoprotein
(immunology)
- Neural Conduction
- Paraproteinemias
(therapy)
- Peripheral Nervous System Diseases
(therapy)
- Recombinant Proteins
- Severity of Illness Index
- Treatment Outcome
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