Nadeau Janel O, Bhibhatbhan Arunee, McDougall David, Toth Cory
Department of Clinical Neurosciences and the University of Calgary, Calgary, Alberta, Canada T2N 4N1.
Clin Neurol Neurosurg. 2010 Jul;112(6):467-9. doi: 10.1016/j.clineuro.2010.02.008. Epub 2010 Mar 15.
Risk factors for adverse events in intravenous immunoglobulin (IVIG) therapy are uncertain. We sought to determine the associations of IVIG-related adverse events in patients with neuromuscular disorders.
We determined the prevalence of adverse events with the use of different forms of IVIG in a tertiary care patient population with neuromuscular diseases. A retrospective assessment for over two decades of patient care was performed.
Adverse events occurred in 43% of patients over time and during 10% of infusions. Prevalence of adverse events, especially headache, was higher for lyophilized forms of IVIG, and increased with cumulative IVIG delivery. Fortunately, serious adverse events were rare for all IVIG preparations. Discontinuation of IVIG therapy occurred most commonly due to perceived inefficacy or adverse events with lyophilized forms of IVIG.
IVIG is generally well tolerated and only rarely associated with serious adverse events, but lyophilized forms of IVIG may be associated with greater prevalence of adverse events in patients with neuromuscular diseases.
静脉注射免疫球蛋白(IVIG)治疗中不良事件的风险因素尚不确定。我们试图确定神经肌肉疾病患者中与IVIG相关的不良事件之间的关联。
我们在患有神经肌肉疾病的三级护理患者群体中,使用不同形式的IVIG确定不良事件的发生率。对超过二十年的患者护理情况进行了回顾性评估。
随着时间推移,43%的患者出现不良事件,在10%的输液过程中出现不良事件。冻干形式的IVIG不良事件发生率更高,尤其是头痛,且随着IVIG累积给药量增加而上升。幸运的是,所有IVIG制剂发生严重不良事件的情况都很罕见。IVIG治疗中断最常见的原因是认为冻干形式的IVIG无效或出现不良事件。
IVIG一般耐受性良好,仅很少与严重不良事件相关,但冻干形式的IVIG可能与神经肌肉疾病患者中更高的不良事件发生率相关。