Abstract Details

Title Safety of Intravenous Immunoglobulin in Acute Treatment of Neuromyelitis Optica: Analysis of 14 Patients

Topic MS and Related Diseases

Presentation(s) P02 - (-)

Poster/Presentation
Number 145

Objective

Background BACKGROUND: NMO is usually a relapsing disease predominantly affecting optic nerves and spinal cord. Prompt treatment of relapses is needed to prevent severe irreversible disability. It is conventional to treat relapses with steroids followed by plasma exchange (PLEX). Like in other antibody mediated disorders, IVIG may be an alternative and/or additional treatment of acute attacks, if steroids/PLEX fail or are contraindicated. No case series has been reported.

Design/Methods DESIGN/METHODS: Clinical notes (demographic, clinical history, radiological findings) of 108 patients with NMO/NMOSD referred to national NMO centre in Liverpool, UK were retrospectively reviewed. 18 patients who had been treated with IVIG were identified.

Results RESULTS: 14/18 patients (4 males, 9 AQP4-Ab positive) with sufficient data were analysed. Median age at time of treatment was 43.6 (7.4-79) years with median duration of disease at time of treatment of 3.8 (0-16.6) years. IVIG was well tolerated in 13/14 cases. None of the patients had to stop infusion or suffered from serious adverse events (SAE) during or shortly after the administration of drug. One patient, aged 79, with cervical myelitis developed chest infection during hospital stay a few days after IVIG and subsequently a myocardial infarction. No other SAE including Posterior reversible encephalopathy syndrome (PRES) were reported. No patient had worsening of NMO symptoms attributable to IVIG.

Conclusions CONCLUSIONS: IVIG was safe and well tolerated in majority of cases but have to be used with caution in elderly patients.

Authors/Disclosures
PRESENTER	No disclosure on file
Jaya Chandran Ramachandra Panicker, MD, MBBS, MRCP (Walton Centre)	No disclosure on file
	No disclosure on file
Mike Boggild (Walton Centre for Neurology and Neurosurgery)	No disclosure on file
	No disclosure on file
Alex Rovira	Alex Rovira has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Alex Rovira has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanofy. Alex Rovira has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Alex Rovira has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Alex Rovira has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Alex Rovira has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Alex Rovira has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Alex Rovira has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Alex Rovira has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. Alex Rovira has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Alex Rovira has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bristol Myers. Alex Rovira has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer. Alex Rovira has stock in Tensor Medical.
Anu Jacob, MD (Cleveland Clinic Abu Dhabi)	Dr. Jacob has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for ALEXION.

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