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Intravenous Immunoglobulin (IVIg)

What is IVIg and how is it used?

“IVIg” is the commonly used acronym for “intravenous immune globulin.” It is also known as pooled human gamma globulin or simply gamma globulin. IVIg has been used for decades in modern medicine in the treatment of a variety of infectious or inflammatory diseases. In patients who are lacking in the antibodies necessary to fight infection IVIg replaces those lost antibodies.
 

Since 1984 IVIg has been used extensively in the treatment of various autoimmune neurological disorders including myasthenia gravis. Studies have shown that IVIg is an effective treatment for many patients with autoimmune myasthenia gravis.

 

How does IVIg work?

IVIg seems to affect the function or the production of antibodies in the immune system. The exact mechanism of how IVIg works in successfully treating myasthenia gravis and other autoimmune disorders is not entirely understood.

 

Since IVIg is a blood product, is it safe?

IVIg is felt to be very safe with regard to exposure to infection or viruses. Donors are screened for certain infections before being allowed to give blood for IVIG. The processing of IVIg inactivates infections such as HIV, Hepatitis B and C. Nonetheless, it is a human blood product that comes from multiple donors.

 

Why has IVIg been prescribed for me?

You may be prescribed IVIg for several reasons.  For many people, IVIg is used short term.  The most common usage is to treat an exacerbation where a patient has worsening symptoms despite other treatments.  IVIg is used to treat patients who are in crisis, or showing signs of impending crisis. IVIg may also be prescribed to bring a person to optimal strength prior to surgery.  Patients with MG who are treated with IVIg can be stabilized, allowing time for other treatments to begin working.  When other therapies are not effective in managing symptoms, a doctor may prescribe IVIg as maintenance therapy.
 

Since IVIg is a blood product, is it safe?

IVIg is felt to be very safe with regard to exposure to infection or viruses. Donors are screened for certain infections before being allowed to give blood for IVIG. The processing of IVIg inactivates infections such as HIV, Hepatitis B and C. Nonetheless, it is a human blood product that comes from multiple donors.

 

Are there adverse effects that occur with IVIg treatments?

Most people with MG tolerate IVIg, well.  . However, there are several adverse effects that may occur. .  You may develop a headache, chills and aches during the infusion. Slowing the infusion rate and using medicines to relieve these symptoms is often helpful.|
 

You may also experience fatigue, fever or nausea that may persist up to 24 hours after the infusion. Other side effects may include a headache, rash or a more severe allergic type reaction. Since IVIg is a highly concentrated protein it may interfere with blood flow and clotting and rarely renal function.  

 

How is treatment with immunoglobulin administered?

IVIg treatments are administered intravenously. The medication is infused slowly over a number of hours. The dose is based on your weight. You might be treated with a series of infusions over a period of three to five days that is repeated at an interval determined by your doctor. For some patients the infusion is given in a physician’s office, while others may have it in the home using a home health agency. If you have been severely weakened, or are showing symptoms of impending crisis, you are likely to be treated in the hospital. A week or two may be required before you feel the onset of improvement, although this varies from patient to patient. The duration of improvement from IVIg varies but typically is a few weeks to a few months.

 

What are other concerns about using IVIg?

IVIg is expensive and so is not often prescribed as first line maintenance therapy.  . It is important to discuss the cost issues with your health insurance provider and infusion provider to prevent financial difficulties.

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