Immunoglobulins are antibody proteins that are secreted by the white blood cells called B-lymphocytes and by plasma cells in response to the presence of a substance that provokes an immune response. This substance is called an antigen.
Intravenous immunoglobulin G (IVIG) is a pooled human immunoglobulin G (IgG) that is presumed to modulate the immune system. It has proven useful in the treatment of a number of autoimmune diseases, but its role in the treatment of MS remains uncertain.
Different trials of IVIG in different types of MS have produced variable results:
- There are some data that suggest that monthly IVIG may be beneficial in reducing relapses and/or inflammatory lesions on MRI in some persons with relapsing remitting MS.
- In other studies, IVIG was not shown to reverse deficits or slow progression in persons with progressive MS.
- A small pilot study has suggested that intravenous immunoglobulin (IVIG) administered for five consecutive days during the first week postpartum, and at six and twelve weeks thereafter, may help prevent postpartum relapses.
- Another small study in people who have experienced a clinically-isolated syndrome indicates that IVIG may delay the onset of clinically-definite MS by prolonging the time to a second attack.
A recent meta-analysis of the various studies that have been done with IVIG concluded that it may be a valuable alternative for the treatment of relapsing-remitting MS (e.g., for those individuals who cannot or will not take one of the approved injectable medications), but cannot presently be considered a first-line treatment.
Additional studies are needed to establish the role of IVIG in the management of MS, and to determine the ideal dosage level.