Abstract
Background: We aimed to assess whether the combination of intravenous immunoglobulin (IVIG) and high-dose intravenous corticosteroid therapy (IVMP) offers superior benefits compared to IVMP alone in managing acute attacks of neuromyelitis optica spectrum disorder (NMOSD).
Methods: A retrospective study was conducted including 71 acute attacks from 63 NMOSD patients treated with IVMP (1000 mg/day for 5 days) combined with IVIG (0.4 g/kg/day for 5 days) and 64 attacks from 56 patients treated with IVMP alone. The Modified Rankin Scale (mRS) score at 3 months, expanded disability status scale (EDSS) scores, and percentage of improvement in EDSS score by seizure type (optic neuritis or myelitis) were compared between the two groups. Furthermore, subgroup analyses were performed on EDSS scores related to visual acuity, pyramidal function, sensory function, and bladder/rectal function.
Results: Both IVMP and the combination of IVMP+IVIG effectively reduced EDSS scores during acute episodes of NMOSD. No significant difference was observed in the mRS score at 3 months or in the remission improvement of EDSS score by seizure type between the two groups. However, a statistically significant difference in the improvement of initial pyramidal function scores was noted in patients with myelitis treated with the combination therapy.
Conclusion: Our study suggests that for NMOSD patients with myelitis, the addition of IVIG to IVMP therapy may provide a certain degree of benefit in terms of motor function recovery. Further prospective studies are needed to confirm these findings.