Immunoglobulin administration for the treatment of CIDP: IVIG or SCIG?

J Neurol Sci. 2020 Jan 15:408:116497. doi: 10.1016/j.jns.2019.116497. Epub 2019 Nov 9.

Abstract

Chronic inflammatory demyelinating polyneuropathy (CIDP) is an acquired neurological disorder characterized clinically by weakness and impaired sensory function evolving over 2 months or more, loss or significant decrease in deep tendon reflexes, and by electrophysiological evidence of peripheral nerve demyelination. Expeditious diagnosis and treatment of CIDP early in the disease course is critical such that irreversible disability can be avoided. Intravenous immunoglobulin (IVIG) is one first-line and maintenance therapy option for CIDP. The US Food & Drug Administration's (FDA's) approval of subcutaneous immunoglobulin (SCIG) in 2018 provides patients with CIDP more treatment options for maintenance therapy. The different options for administration of IG treatment create the need for information to assist clinicians and patients in choosing the optimal therapeutic approach. Considerations for pharmacokinetics, administration procedures, adverse events, patient variables, and cost will all be discussed in this article.

Keywords: Chronic inflammatory demyelinating polyneuropathy; Intravenous immunoglobulin; Maintenance therapy; Route of administration comparison; Subcutaneous immunoglobulin.

Publication types

  • Review

MeSH terms

  • Humans
  • Immunoglobulins, Intravenous / administration & dosage*
  • Immunoglobulins, Intravenous / pharmacokinetics
  • Infusions, Subcutaneous / methods*
  • Injections, Subcutaneous
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / diagnosis
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / drug therapy*
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / metabolism
  • Randomized Controlled Trials as Topic / methods*

Substances

  • Immunoglobulins, Intravenous