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慢性炎症性脱髓鞘性多发性神经根神经病的 IV 免疫球蛋白维持治疗。

Maintenance IV immunoglobulin treatment in chronic inflammatory demyelinating polyradiculoneuropathy.

机构信息

Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.

Department of Neurology, Albert Schweitzer Hospital, Dordrecht, The Netherlands.

出版信息

J Peripher Nerv Syst. 2017 Dec;22(4):425-432. doi: 10.1111/jns.12242. Epub 2017 Nov 21.

Abstract

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) patients treated with intravenous immunoglobulin (IVIg) usually start with a standard dosage of 2 g/kg bodyweight. Only a minority of patients has a sustained improvement, and most require ongoing maintenance treatment. Preferred IVIg regimens, however, vary considerably between doctors and at present it is unknown which is optimal. As there are also large differences in IVIg dosage and interval requirements between patients, optimal IVIg maintenance treatment of CIDP is even more complex. The lack of evidence-based guidelines on how IVIg maintenance treatment should be administered may potentially lead to under- or overtreatment of this expensive therapy. We provide an overview of published practical IVIg maintenance treatment regimens, IVIg maintenance schedules used in randomized controlled trials and one based upon our own long-term experience on how this treatment could be given in CIDP.

摘要

慢性炎症性脱髓鞘性多发性神经病(CIDP)患者通常采用静脉注射免疫球蛋白(IVIg)进行治疗,起始剂量为 2g/kg 体重。仅有少数患者有持续改善,大多数患者需要持续维持治疗。然而,医生之间和目前尚不清楚哪种方案最理想,首选的 IVIg 方案差异很大。由于患者之间的 IVIg 剂量和间隔要求也存在很大差异,因此 CIDP 的最佳 IVIg 维持治疗更加复杂。由于缺乏关于如何进行 IVIg 维持治疗的循证指南,这种昂贵治疗可能存在治疗不足或过度治疗的潜在风险。我们提供了已发表的实用 IVIg 维持治疗方案概述、随机对照试验中使用的 IVIg 维持方案以及根据我们自己的长期经验提出的一种治疗方案,以探讨 CIDP 患者的 IVIg 维持治疗。

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