Contributions
Abstract: P1194
Type: Poster
Abstract Category: Therapy - disease modifying - Immunomodulation/Immunosuppression
The efficacy of intravenous immune globulin (IVIG) for preventing relapses in neuromyelitis optica (NMO) and its spectrum disorders (NMOSD) has been investigated in a limited number of studies. The purpose of this study was to determine the effectiveness of IVIG in the prevention of NMO/NMOSD relapses. We identified 40 NMO-IgG-positive NMO/NMOSD patients who were treated with regular IVIG infusions. Five patients were excluded due to short follow-up periods (< 6 months), and the remaining 35 patients (34 women and 1 man; median age 44 years) were included. The outcome was evaluated based on decrement in the number of relapses, annualized relapse rates (ARR), and expanded disability status scale (EDSS) scores before and after treatment. IVIG (0.4g/kg/day) were infused every 2 to 3 months. The median duration of treatment was 3.0 years (range, 0.5 to 9.3 years). The median number of infusions was 18 (range, 3 to 53). Before beginning of IVIG, 17 patients (49%) received plasma exchanges for the treatment of acute relapse. 15 patients discontinued IVIG infusions after a median period of 1.5 years (range, 0.5-5.4 years). The median disease duration at the start of IVIG treatment was 4 years (range, 0.3 to 13 years). Median number of relapses prior to IVIG initiation was 4 (range, 1 to 14 relapses) with median ARR of 1 (range, 0.3 to 4.0). Median number of relapses and median ARR significantly decreased from 4.0 to 1.0 (p=0.000) and 1 to 0.3 (p=0.000) respectively. 12 patients (34%) remained free of relapses. After discontinuation of IVIG, recurrence was observed in 5 patients (33%). The median EDSS score was 3.5 at the IVIG initiation (range, 0-8.5) and 3.5 at last follow-up (range, 0-8.5). Median EDSS on IVIG remained unchanged (p=0.805). The EDSS scores stabilized in 16 patients (46%) and improved in 11 patients (31%). Relapse rates decreased and disability stabilized or improved in 27 patients (77%). In our study, regular maintenance therapy with IVIG reduced the relapse frequency and stabilized or improved disability. Our results suggest that IVIG may be an effective therapy for the prevention of relapse in NMO/NMOSD. Further randomized controlled trials are necessary to prove the effectiveness of IVIG in the treatment of NMO/NMOSD.
Disclosure: Hyunjin Kim: nothing to dosclosure, Young-Min Lim: nothing to disclosure, Joo-Yea Jin: nothing to disclosure, Kwang-Kuk Kim: nothing to disclosure
Abstract: P1194
Type: Poster
Abstract Category: Therapy - disease modifying - Immunomodulation/Immunosuppression
The efficacy of intravenous immune globulin (IVIG) for preventing relapses in neuromyelitis optica (NMO) and its spectrum disorders (NMOSD) has been investigated in a limited number of studies. The purpose of this study was to determine the effectiveness of IVIG in the prevention of NMO/NMOSD relapses. We identified 40 NMO-IgG-positive NMO/NMOSD patients who were treated with regular IVIG infusions. Five patients were excluded due to short follow-up periods (< 6 months), and the remaining 35 patients (34 women and 1 man; median age 44 years) were included. The outcome was evaluated based on decrement in the number of relapses, annualized relapse rates (ARR), and expanded disability status scale (EDSS) scores before and after treatment. IVIG (0.4g/kg/day) were infused every 2 to 3 months. The median duration of treatment was 3.0 years (range, 0.5 to 9.3 years). The median number of infusions was 18 (range, 3 to 53). Before beginning of IVIG, 17 patients (49%) received plasma exchanges for the treatment of acute relapse. 15 patients discontinued IVIG infusions after a median period of 1.5 years (range, 0.5-5.4 years). The median disease duration at the start of IVIG treatment was 4 years (range, 0.3 to 13 years). Median number of relapses prior to IVIG initiation was 4 (range, 1 to 14 relapses) with median ARR of 1 (range, 0.3 to 4.0). Median number of relapses and median ARR significantly decreased from 4.0 to 1.0 (p=0.000) and 1 to 0.3 (p=0.000) respectively. 12 patients (34%) remained free of relapses. After discontinuation of IVIG, recurrence was observed in 5 patients (33%). The median EDSS score was 3.5 at the IVIG initiation (range, 0-8.5) and 3.5 at last follow-up (range, 0-8.5). Median EDSS on IVIG remained unchanged (p=0.805). The EDSS scores stabilized in 16 patients (46%) and improved in 11 patients (31%). Relapse rates decreased and disability stabilized or improved in 27 patients (77%). In our study, regular maintenance therapy with IVIG reduced the relapse frequency and stabilized or improved disability. Our results suggest that IVIG may be an effective therapy for the prevention of relapse in NMO/NMOSD. Further randomized controlled trials are necessary to prove the effectiveness of IVIG in the treatment of NMO/NMOSD.
Disclosure: Hyunjin Kim: nothing to dosclosure, Young-Min Lim: nothing to disclosure, Joo-Yea Jin: nothing to disclosure, Kwang-Kuk Kim: nothing to disclosure