Neuromuscular DiseasesNeuromuscular DiseasesНервно-мышечные болезни2222-87212413-0443Publishing House ABV Press31210.17650/2222-8721-2019-9-1-32-51LECTURES AND REVIEWSЛЕКЦИИ И ОБЗОРЫImmunoglobulins in neurological practice: a review of the literatureИммуноглобулины в неврологической практике: обзор литературыhttps://orcid.org/0000-0003-3292-2758NikitinS. S.НикитинC. С.
Russian Federation

Build. 2, 17 Krzhizhanovskogo St., Moscow 117258, 

Build 15, 24 Kashirskoe Shosse, Moscow 117478

117258 Москва, ул. Кржижановского, 17/2, 

117478 Москва, Каширское шоссе, 24/15

https://orcid.org/0000-0003-3232-1573BoriskinaL. M.БорискинаЛ. М.
Russian Federation

Build 15, 24 Kashirskoe Shosse, Moscow 117478, 

Build 13, 13 Myasnitskaya St., Moscow 101000

Лидия Михайловна Борискина

117478 Москва, Каширское шоссе, 24/15, 

101000 Москва, ул. Мясницкая, 13/13

boriskina.lidiya@gmail.comMedical Center “Practical Neurology”Медицинский центр «Практическая неврология»Association of Neuromuscular Disorders SpecialistsРегиональная общественная организация «Общество специалистов по нервно-мышечным болезням»“Normodent Center” «Clinic Central»«Клиника Центральная» ООО «Нормодент-Центр»240420199132512404201924042019Copyright ©; 2019, Nikitin S.S., Boriskina L.M.Copyright ©; 2019, Никитин C.С., Борискина Л.М.2019Nikitin S.S., Boriskina L.M.Никитин C.С., Борискина Л.М.https://creativecommons.org/licenses/by/4.0https://nmb.abvpress.ru/jour/article/view/312

Today intravenous immunoglobulins are used increasingly in the management of patients with neurological conditions. The efficacy and safety of intravenous immunoglobulins treatment in chronic inflammatory demyelinating polyradiculoneuropathy, Guillain–Barre syndrome and multifocal motor neuropathy have been established in randomized controlled trials and declared in systematic reviews. There are discussions about the dose, timing, duration and necessity of repeated infusions in these disorders. The intravenous immunoglobulins treatment is an option in myasthenia gravis crisis and exacerbations the disease, stiff-person syndrome, a second-line therapy in dermatomyositis and some patients with polymyositis. The use of intravenous immunoglobulins in patients with multiple sclerosis, inclusion body myositis, resistant epilepsy is not finally proved. The review discussed the data of immunoglobulins efficacy in neurological disorders based on informative studies with an emphasis on the main criteria for choosing a drug for effective high-dose intravenous immunotherapy.

 Сегодня высокодозная терапия иммуноглобулинами человека получает все большее распространение в лечении болезней нервной системы. Эффективность и безопасность использования иммуноглобулинов доказана в рандомизированных контролируемых исследованиях у пациентов с хронической воспалительной демиелинизирующей полинейропатией, синдромом Гийена–Барре, мультифокальной моторной нейропатией, что отражено в систематических обзорах. Обсуждаются вопросы о дозах, интервалах и продолжительности лечения и необходимости повторных инфузий при этих состояниях. Использование высокодозной терапии иммуноглобулинами является опцией при миастенических кризах и обострениях миастении гравис, синдроме ригидного человека, а также терапией 2-й линии при дерматомиозите и в некоторых случаях при полимиозите. Применение иммуноглобулинов при рассеянном склерозе, миозите с включениями, резистентной эпилепсии остается не до конца обоснованной. В обзоре обсуждается эффективность высокодозной терапии иммуноглобулинами в неврологии на основании информативных исследований, с учетом основных критериев выбора препарата для адекватной внутривенной иммунотерапии.

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