Pharmacokinetics and pharmacodynamics of Intravenous Immunoglobulin G maintenance therapy in Chronic Immune‐mediated Neuropathies

The regimen for intravenous immunoglobulin (IVIg) maintenance treatment varies considerably between patients with chronic immune-mediated neuropathies. Although it is widely recognized that treatment regimens should be improved, detailed pharmacokinetics of IVIg have not been established. We aimed to determine the pharmacokinetics of IVIg maintenance treatment in patients with clinically stable, treatment-dependent chronic immune-mediated neuropathy. Patients received a median IVIg dose of 30 (15 – 70) grams every 14 (7 – 28) days resulting in high IgG peak levels (median 25.9 g/L, range 16.7 – 41.0 g/L) and trough levels (median 16.1 g/L, range 9.7 – 23.6 g/L). IgG pharmacokinetic parameters, including half-life (median 23.1 days, range 11 - 60 days), were constant during subsequent courses in the same patients, but varied considerably between patients. The IgG levels at one week after infusion correlated with grip strength. These results provide insight into the pharmacokinetics of IVIg maintenance treatment in patients with chronic immune-mediated neuropathies. This article is protected by copyright. All rights reserved.