Intravenous Immunoglobulin Sharply Reduces Relapse Rate in a Series of Patients with Neuromyelitis Optica

With the objective of evaluating the safety and tolerability of intravenous immune globulin (IVIG) as a treatment for neuromyelitis optica (NMO), a team of Spanish investigators administered IVIG (0.7 g/kg body weight for three days) every two months to eight patients meeting Wingerchuk’s revised diagnostic criteria for the disorder. Five patients had relapsing optic neuritis with or without myelitis, and three had recurrent longitudinally extensive transverse myelitis. The mean age of onset was 20.5 years (range 7 years to 31 years).

Following 83 total infusions (range 4 to 21 per patient) and a mean follow-up time of 19.3 months (range 6 to 39 months), only a few minor adverse events had occurred: headache in three patients and a mild cutaneous eruption in a single patient. The relapse rate decreased from a mean of 1.8 attacks in the previous year to 0.006 attacks during follow-up (P = 0.01). The Expanded Disability Status Scale (EDSS) score fell from 3.3 ± 1.3 to 2.5 ± 1.5 (P = 0.04).

The investigators concluded that treatment with IVIG is safe and well-tolerated, and it may be used as a treatment alternative for NMO spectrum disorders.