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This version was published on August 1, 2007
Multiple Sclerosis, Vol. 13, No. 7, 900-908 (2007)
DOI: 10.1177/1352458506075654

A dose comparison study of IVIG in postpartum relapsing-remitting multiple sclerosis

Judith Haas

Jüdisches Krankenhaus Berlin, Abteilung für Neurologie, Heinz-Galinski-Str. 1, 13347 Berlin, Germany

Otto Roelf Hommes

European Charcot Foundation, Hoeveveld 18A, 6584 GG Molenhoek (Nijmegen area), The Netherlands, info{at}charcot-ms.eu

Untreated patients with relapsing-remitting multiple sclerosis (RRMS) have an elevated risk of exacerbation in the first 3 months postpartum. Pregnant patients (n =173) with RRMS and with at least one relapse in the two years before pregnancy were enrolled in this multinational, multicentre, randomized double-blind clinical trial investigating different doses of intravenous immunoglobulin (IVIG) treatment in the 6 months postpartum. Group I (unloaded) received 150 mg/kg body weight (BW) IVIG on Day 1, then placebo infusions on Day 2 and Day 3. Group II (loaded) received 450, 300 and 150 mg/kg BW on Days 1, 2 and 3 respectively. Both groups then received 150 mg/kg BW five times in four-weekly intervals. The ratio of patients remaining relapse-free during the first 3 months postpartum did not differ significantly between both groups (81.5% in Group II versus 75.6% in Group I). The ratio of relapse-free patients was independent of dosage in the subgroup of patients breastfeeding for at least 3 months (89% in Group I versus 90% in Group II). The mean annualized relapse rate (ARR) after pregnancy did not show an increased risk for exacerbation, but returned to prepregnancy level within 3 months independent of dosage. The treatment was well tolerated. Multiple Sclerosis 2007; 13: 900-908. http://msj.sagepub.com

Key Words: clinical trial • immunoglobulin • intravenous • multiple sclerosis • postpartum • relapsingremitting


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