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Randomized double-blind placebo-controlled trial of the corticosteroid-sparing effects of immunoglobulin in myasthenia gravis

The result's identifiers

  • Result code in IS VaVaI

    <a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00843989%3A_____%2F23%3AE0110162" target="_blank" >RIV/00843989:_____/23:E0110162 - isvavai.cz</a>

  • Alternative codes found

    RIV/00216224:14110/23:00131012 RIV/65269705:_____/23:00077929

  • Result on the web

    <a href="https://n.neurology.org/content/neurology/100/7/e671.full.pdf" target="_blank" >https://n.neurology.org/content/neurology/100/7/e671.full.pdf</a>

  • DOI - Digital Object Identifier

    <a href="http://dx.doi.org/10.1212/WNL.0000000000201501" target="_blank" >10.1212/WNL.0000000000201501</a>

Alternative languages

  • Result language

    angličtina

  • Original language name

    Randomized double-blind placebo-controlled trial of the corticosteroid-sparing effects of immunoglobulin in myasthenia gravis

  • Original language description

    ackground and objectives: Myasthenia gravis (MG) is an autoimmune disease characterized by dysfunction at the neuromuscular junction. Treatment frequently includes corticosteroids (CSs) and IV immunoglobulin (IVIG). This study was conducted to determine whether immune globulin (human), 10% caprylate/chromatography purified (IGIV-C) could facilitate CS dose reduction in CS-dependent patients with MG. Methods: In this randomized double-blind placebo-controlled trial, CS-dependent patients with MG (Myasthenia Gravis Foundation of America Class II-Iva; AChR+) received a loading dose of 2 g/kg IGIV-C over 2 days (maximum 80 g/d) or placebo at week 0 (baseline). Maintenance doses (1 g/kg IGIV-C or placebo) were administered every 3 weeks through week 36. Tapering of CS was initiated at week 9 and continued through week 36 unless the patient worsened (quantitative MG score ?4 points from baseline). CS doses were increased (based on the current CS dose) in patients who worsened. Patients were withdrawn if worsening failed to improve within 6 weeks or if a second CS increase was required. The primary efficacy end point (at week 39) was a ?50% reduction in CS dose. Secondary and safety end points were assessed throughout the study and follow-up (weeks 42 and 45). The study results and full protocol are available at clinicaltrials.gov/ct2/show/NCT02473965. Results: The primary end point (?50% reduction in CS dose) showed no significant difference between the IGIV-C treatment (60.0% of patients) and placebo (63.3%). There were no significant differences for secondary end points. Safety data indicated that IGIV-C was well tolerated. Discussion: In this study, IGIV-C was not more effective than placebo in reducing daily CS dose. These results suggest that the effects of IGIV-C and CS are not synergistic and may be mechanistically different. Trial registration information: The trial was registered on clinicaltrialsregister.eu (EudraCT #: 2013-005099-17) and clinicaltrials.gov (...

  • Czech name

  • Czech description

Classification

  • Type

    J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database

  • CEP classification

  • OECD FORD branch

    30210 - Clinical neurology

Result continuities

  • Project

  • Continuities

    N - Vyzkumna aktivita podporovana z neverejnych zdroju

Others

  • Publication year

    2023

  • Confidentiality

    S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Data specific for result type

  • Name of the periodical

    Neurology

  • ISSN

    0028-3878

  • e-ISSN

    1526-632X

  • Volume of the periodical

    100

  • Issue of the periodical within the volume

    7

  • Country of publishing house

    US - UNITED STATES

  • Number of pages

    1

  • Pages from-to

    e671-e682

  • UT code for WoS article

    000983098800016

  • EID of the result in the Scopus database

    2-s2.0-85148113088