Multiple Sclerosis International / 2015 / Article / Tab 1

Review Article

Intrathecal IgG Synthesis: A Resistant and Valuable Target for Future Multiple Sclerosis Treatments

Table 1

Posttreatment change in intrathecal synthesis.

ReferencesDrugsTime to follow up LPIgG index1OCB+2IT synthesis3

[79]IV methylpred.
(1 g/d/3 d)
75 daysIgG 1.7 → 1.1**7/9 → 5/8Tourt. 26 → 13 mg/L*

[78]IV methylpred.
(1 g/d/10 d)
10110 daysIgG 1.05 → 0.98**
IgM 0.13 → 0.12
92% → 82%**IgGLoc 31 → 11 mg/L**
(85% → 70%**)
IgMLoc 1.0 → 0.4 mg/L**
(32% → 27%**)

[94]CCNU410 weeksN/AN/ATourt.
Baseline: 59.5 ± 34.8 mg/d
Weeks 1-2: −6.3 ± 5.3 mg/d
Weeks 3–5: −6.8 ± 8.1 mg/d
Weeks 6–10: −11.8 ± 7.5 mg/d*

[134]Natalizumab610 months(2/4 → 1/6)(6/6 → 2/6)N/A

[136]Natalizumab2424 months0.88 → 0.64**
67% → 33%**
92% → 42%**IgGLoc  0.52 → 0.0 mg/L

[137]Natalizumab2460 weeksUnchanged(17/17 → 16/17)N/A

[138]Natalizumab5930 monthsDecreased
(−0.18)*
N/A → 94%IgGLoc  −12.1 mg/L**
IgMLoc  −0.2 mg/L**

[135]Natalizumab7330 monthsN/A100% → 84%**80% → 55%**

[76]IV rituximab1324 weeksUnchangedUnchangedUnchanged

[152]IT rituximab 10 mg/m/2 months12 monthsIgG 4.02 → 3.86UnchangedN/A

Unless explicitly mentioned, no change is statistically significant. 1Mean IgG index is provided when available: elsewhere abnormal IgG indexes (>0.7) are provided as number or per cent of patients. 2OCB (IEF) are described as number or per cent of patients. Owing to subjectivity in counting, changes in mean OCB number are not taken into account. 3IT synthesis is assessed when > . Proportion of abnormal synthesis, IgGLoc, or mean changes of IgGLoc are reported. N/A: not assessed. Follow-up results without statistically significant changes are categorized as “unchanged.” Since our objective was an eventual normalization of intrathecal synthesis, we did not report synthesis fluctuations when they were not associated with at least normalization of results in some patients. For example, in [76], IgG synthesis rate decreased by 30% in 6 while increasing by 30% in 3 patients, but none achieved normal synthesis. *; **.