Multiple Sclerosis (MS) is a chronic neurological condition that affects the brain, spinal cord, and optic nerves, disrupting communication pathways within the central nervous system. This disease can lead to a wide range of symptoms, from mild to severe, impacting mobility, speech, vision, and sensation. While many treatments exist to manage MS, Intravenous Immunoglobulin (IVIG) is a therapy that may be considered for certain individuals with the condition.
Understanding IVIG
Intravenous Immunoglobulin (IVIG) is a biological product derived from the plasma of thousands of healthy human donors. It consists primarily of pooled antibodies, which are proteins naturally produced by the immune system to fight infections and diseases. IVIG is carefully processed to ensure safety and purity.
IVIG modulates the immune system, helping to prevent the body from attacking itself and reducing inflammation. It is also used for immunodeficiency disorders where the body lacks antibodies. This therapy provides diverse antibodies, strengthening the body’s defenses and addressing autoimmune responses.
How IVIG Works in Multiple Sclerosis
IVIG has immunomodulatory actions in Multiple Sclerosis. It influences immune cell function, preventing B and T cells from producing autoantibodies that damage nerve tissues. This suppresses the abnormal immune responses characteristic of autoimmune diseases.
IVIG also neutralizes harmful autoantibodies that contribute to myelin destruction. Its anti-inflammatory properties reduce central nervous system inflammation, a hallmark of MS pathology. Beyond suppressing inflammation, IVIG may promote remyelination, the process of repairing or regenerating myelin sheaths. This nerve protection can influence disability and disease progression.
When IVIG is Used for Multiple Sclerosis
IVIG is not a first-line MS treatment but is considered in specific clinical scenarios, especially when conventional disease-modifying therapies are unsuitable. It is an option for patients who cannot tolerate standard MS medications or when other treatments have been ineffective for relapsing-remitting MS (RRMS).
IVIG is used during pregnancy or postpartum when conventional MS drugs are contraindicated, as studies show it reduces relapses in new mothers. While not a primary treatment for acute relapses, IVIG may be a third-line option if corticosteroids and plasma exchange are not tolerated or fail to respond. Its use in MS is individualized and determined by a neurologist, often off-label.
Receiving IVIG Treatment
IVIG therapy is administered as an intravenous infusion, delivered directly into a vein, typically in the arm. Infusion sessions usually last one to four hours. Frequency depends on the specific condition and individual response; high doses are generally required monthly for several months to years for immunomodulation.
Treatment sessions commonly take place in a clinic or hospital setting, although home infusions are also possible. Before an infusion, patients are advised to hydrate to minimize potential side effects. During the infusion, healthcare professionals monitor blood pressure, pulse, and temperature for reactions. The infusion rate is typically started slowly and gradually increased if no adverse reactions occur.
Potential Side Effects
While IVIG is generally considered safe, some individuals may experience side effects during or after infusion. Mild, transient reactions are common, including headaches, fever, chills, fatigue, nausea, muscle aches, or a rash. These often occur within the first hour or within a few hours to days afterward.
Rare, severe side effects include allergic reactions (e.g., anaphylaxis), kidney issues, blood clots, or aseptic meningitis (brain lining inflammation). Patients are monitored during infusions to manage effects, and providers can adjust the rate or dosage to reduce discomfort.