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Arch Neurol. 2005 Nov;62(11):1689-93.

Treatment of myasthenia gravis exacerbation with intravenous immunoglobulin: a randomized double-blind clinical trial.

Author information

1
Medical Intensive Care Unit, Raymond Poincaré Teaching Hospital, Assistance publique-Hôpitaux de Paris, Garches, France. mp.gajdos@9online.fr

Abstract

BACKGROUND:

The optimal dose of intravenous immunoglobulin (IVIG) in acute exacerbation of myasthenia gravis remains unknown. Increasing the treatment duration might provide added efficacy.

OBJECTIVE:

To determine the optimal dose of IVIG for treating myasthenia gravis exacerbation.

DESIGN:

Randomized double-blind placebo-controlled multicenter trial designed to demonstrate superiority of the 2 g/kg dose over the 1 g/kg dose of IVIG, conducted between November 13, 1996, and October 26, 2002.

PARTICIPANTS:

One hundred seventy-three patients aged 15 to 85 years with acute exacerbation of myasthenia gravis.

INTERVENTION:

Participants were randomly assigned to receive 1 g/kg of IVIG on day 1 and placebo on day 2 (group 1) vs 1 g/kg of IVIG on 2 consecutive days (group 2).

MAIN OUTCOME MEASURE:

Improvement in the myasthenic muscular score after 2 weeks.

RESULTS:

The mean improvements in the myasthenic muscular scores after 2 weeks were 15.49 points (95% confidence interval, 12.09-18.90 points) in group 1 and 19.33 points (95% confidence interval, 15.82-22.85 points) in group 2. However, the difference between the 2 groups was not significant (effect size, 3.84 [95% confidence interval, -1.03 to 8.71]; P = .12).

CONCLUSION:

This trial found no significant superiority of 2 g/kg over 1 g/kg of IVIG in the treatment of myasthenia gravis exacerbation.

PMID:
16286541
DOI:
10.1001/archneur.62.11.1689
[Indexed for MEDLINE]

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