Patients being treated for myasthenia gravis (MG) can successfully transition from intravenous immunoglobulin (IVIG) to subcutaneous immunoglobulin (SCIG) and from SCIG to IVIG, according to a study published in the European Journal of Neurology.

Current treatment of MG includes symptomatic and course-modifying therapies that target the immune system, according to the study. IVIG and subcutaneous immunoglobulin (SCIG) are both viable options for chronic therapy. 

The retrospective study looked at charts of 34 patients with MG between January 2015 and January 2020 who were treated with IVIG/SCIG for at least 6 months. The primary outcome was the mean change in Myasthenia Gravis Impairment Index (MGII) after treatment with IG. Secondary outcomes were the change in pyridostigmine, immunosuppressive medications, and patientā€reported “percentage of normal,” according to the study.   

Of the 34 patients with MG treated with Ig therapy, 30 were treated with both IVIG and SCIG, 3 were treated with SCIG only, and 1 was treated with IVIG only. The range of duration of IVIG treatment was 3 to 64 months, and the range of duration of treatment with SCIG was 5 to 45 months. Both therapies were associated with significant reductions in MGII scores, according to the study. 

“Our study results suggest that patients can be successfully transitioned to IVIG and from IVIG to SCIG in the chronic treatment of generalized MG with reductions in impairments and use of other medications and improvement in overall status with Ig therapy,” the study authors wrote. “Prospective, randomized studies are needed to clarify costs and comparative effectiveness.”

Reference
Alcantara, M., Sarpong, E., Barnett, C., Katzberg, H., Bril, v. Chronic immunoglobulin maintenance therapy in myasthenia gravis [Journal Article] September 22, 2020. European Journal of Neurology.  https://doi.org/10.1111/ene.14547  Accessed October 22, 2020.