Maintenance dosing of immunoglobulin therapy in patients with inflammatory neuropathy

<h3>Background</h3> Immunoglobulin is one of the cornerstones of treatment for the management of inflammatory neuropathy (CIDP and MMN). There is limited practical advice found in the literature on how best to initially manage the dose of Ig therapy and data is lacking on long-term stable maintenance dosing. Determining a ‘typical’ dose per patient could help provide the clinician with an initial maintenance treatment target and help guide national standards of practice. <h3>Methods</h3> We analysed the dosing record for all our patients (120) receiving Ig therapy for inflammatory neuropathy in a large tertiary neurosciences centre for more than one year. 102 patients were deemed to be clinically stable on maintenance therapy &gt; 6 months. <h3>Results</h3> Patients with CIDP generally required lower maintenance IVIg doses; median 1.3g/Kg IBW (42 patients) Vs 2.05g IVIg for MMN (14 patients). SCIg dosing showed the opposite with a CIDP median dose of 1.2g SCIg/kg IBW per month (38 patients) Vs 0.8g SCIg/Kg IBW per month for MMN (8 patients), reflective for our reticence to transfer all but the most stable of MMN patients to SCIg. <h3>Conclusions</h3> We present useful data on long-term maintenance Ig dosing in inflammatory neuropathies that we hope will help inform clinical practice.