IVIG May Confer Relief in Specific Types of Neuropathy Associated with Sjögren’s Syndrome

Administration of high-dose intravenous immunoglobulin (IVIG) may provide symptomatic relief in patients with sensorimotor neuropathy or nonataxic sensory neuropathy associated with primary Sjögren’s syndrome, according to a retrospective analysis of 19 French Sjögren’s patients.The median duration of neuropathy in these patients was nine years at the time of treatment. All patients received 2 g/kg of IVIG per month in divided doses for a median of seven months. Response was assessed using the Modified Rankin Scale and a global evaluation by the practitioner.

All five patients with sensorimotor neuropathy, all four patients with nonataxic neuropathy and a sole patient with conduction block improved or stabilized on IVIG therapy. In contrast, just two of nine patients with ataxic neuropathy improved, while three remained stable and four worsened. After four to 12 months of treatment, five treatment-responsive patients were able to have their IVIG infusions spaced to every two to three months. Ten of 13 steroid-dependent patients were able to reduce their prednisone dosage from an average of 15 mg daily before IVIG to 10 mg daily with IVIG therapy.

“Symptomatic treatment should be tested in patients with Sjögren’s syndrome without necrotizing vasculitis-related neuropathy,” the investigators concluded. “Further studies are necessary to investigate the optimal number of IVIG courses necessary to definitively assess the efficacy or the failure of the treatment.”