皮下注射与静脉注射免疫球蛋白治疗慢性自身免疫性神经病：一项荟萃分析。

Subcutaneous versus intravenous immunoglobulin for chronic autoimmune neuropathies: A meta-analysis.

作者信息

Racosta Juan M, Sposato Luciano A, Kimpinski Kurt

机构信息

Department of Clinical Neurological Sciences, Room C7-131, University Hospital, London Health Sciences Centre, 339 Windermere Road, London, Ontario, Canada, N6A 5A5.

Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.

出版信息

Muscle Nerve. 2017 Jun;55(6):802-809. doi: 10.1002/mus.25409. Epub 2017 Feb 9.

DOI:10.1002/mus.25409

PMID:27649063

Abstract

INTRODUCTION

High-dose intravenous immunoglobulin (IVIg) is an evidence-based treatment for multifocal motor neuropathy (MMN) and chronic inflammatory demyelinating polyneuropathy (CIDP). Recently, subcutaneous immunoglobulin (SC-Ig) has received increasing attention.

METHODS

We performed a meta-analysis of reports of efficacy and safety of SC-Ig versus IVIg for inflammatory demyelinating polyneuropathies.

RESULTS

A total of 8 studies comprising 138 patients (50 with MMN and 88 with chronic CIDP) were included in the meta-analysis. There were no significant differences in muscle strength outcomes in MMN and CIDP with Sc-Ig (MMN: effect size [ES] = 0.65, 95% confidence interval [CI] = -0.31-1.61; CIDP: ES = 0.84, 95% CI = -0.01-1.69). Additionally SC-Ig had a 28% reduction in relative risk (RR) of moderate and/or systemic adverse effects (95% CI = 0.11-0.76).

CONCLUSIONS

The efficacy of SC-Ig is similar to IVIg for CIDP and MMN and has a significant safety profile. Muscle Nerve 55: 802-809, 2017.

摘要

引言

大剂量静脉注射免疫球蛋白（IVIg）是治疗多灶性运动神经病（MMN）和慢性炎症性脱髓鞘性多发性神经病（CIDP）的循证治疗方法。近来，皮下注射免疫球蛋白（SC-Ig）受到越来越多的关注。

方法

我们对SC-Ig与IVIg治疗炎症性脱髓鞘性多发性神经病的疗效和安全性报告进行了荟萃分析。

结果

荟萃分析共纳入8项研究，包括138例患者（50例MMN患者和88例慢性CIDP患者）。对于MMN和CIDP患者，使用SC-Ig治疗后的肌肉力量结果无显著差异（MMN：效应量[ES]=0.65，95%置信区间[CI]=-0.31-1.61；CIDP：ES=0.84，95%CI=-0.01-1.69）。此外，SC-Ig导致中度和/或全身不良反应的相对风险（RR）降低了28%（95%CI=0.11-0.76）。