Cursiefen S, Mäurer M
Neurologische Klinik mit Poliklinik, Universitätsklinikum Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany.
Nervenarzt. 2008 Sep;79 Suppl 2:67-74; quiz 75-6. doi: 10.1007/s00115-008-2461-y.
Intravenous immunoglobulins (IVIg) have been used for treating various neuroimmunological diseases. Over the past decade their efficacy could be demonstrated in placebo-controlled, double-blinded clinical trials. Use of IVIg has become the first-line treatment for Guillain-Barré syndrome (GBS), chronic inflammatory demyelinating polyneuropathy, multifocal motor neuropathy, and rapidly worsening myasthenia gravis. It is also a second-line treatment for dermatomyositis, polymyositis, stiff-person syndrome, and pregnancy- and postpartum-related relapses in multiple sclerosis. Intravenous immunoglobulin is easily available, its administration is uncomplicated, and it has an excellent safety profile. In Germany it has been approved only for GBS; for other indications it has to be used off-label. Here we review the clinical applications and recommendations for the use of IVIg in neurological diseases.
静脉注射免疫球蛋白(IVIg)已被用于治疗各种神经免疫性疾病。在过去十年中,其疗效已在安慰剂对照的双盲临床试验中得到证实。IVIg的使用已成为吉兰-巴雷综合征(GBS)、慢性炎症性脱髓鞘性多发性神经病、多灶性运动神经病以及快速进展性重症肌无力的一线治疗方法。它也是皮肌炎、多发性肌炎、僵人综合征以及多发性硬化症中与妊娠和产后相关复发的二线治疗方法。静脉注射免疫球蛋白易于获取,给药方式简单,且安全性极佳。在德国,它仅被批准用于GBS;对于其他适应症,必须超适应症使用。在此,我们综述IVIg在神经系统疾病中的临床应用及使用建议。