Researchers report comparable efficacy of IVIG and PLEX in a randomized, controlled trial, but the lack of a noninferiority study design precludes this conclusion.
Myasthenia gravis (MG) is an autoimmune disorder in which antibodies directed against either the acetylcholine receptor or muscle-specific kinase impair neuromuscular transmission. Intravenous immunoglobulin (IVIG) and plasma exchange (PLEX) are immunomodulation therapies that are widely believed to benefit patients whose MG is worsening; however, evidence from randomized, controlled trials is lacking for PLEX and inconsistent for IVIG. Now, in an evaluator-masked study, researchers randomized 84 patients with moderate-to-severe MG to receive IVIG therapy (1 g/kg/day for 2 days) or PLEX (5 exchanges of 1 plasma volume with 5% albumin replacement fluid every other day). A manufacturer of IVIG funded the trial.
From baseline to 14 days after f…
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DisclosuresGrant / Research supportNIH NeuroBioBank; ALS Association; NIH/National Institute of Neurological Disorders and Stroke; NIH/National Center for Advancing Translational Sciences; FDA; Department of Defense
Editorial boardsCochrane Collaboration
Leadership positions in professional societiesMuscle Study Group Executive Committee
DisclosuresGrant / Research supportNIH NeuroBioBank; ALS Association; NIH/National Institute of Neurological Disorders and Stroke; NIH/National Center for Advancing Translational Sciences; FDA; Department of Defense
Editorial boardsCochrane Collaboration
Leadership positions in professional societiesMuscle Study Group Executive Committee