Individualized immunoglobulin therapy in chronic immune‐mediated peripheral neuropathies.
Abstract: Despite the well‐recognized importance of immunoglobulin therapy individualization during the treatment of chronic inflammatory demyelinating polyneuropathy (CIDP), the pathway to best achieve optimization is unknown. There are many pharmacokinetic and immunobiologic variables that can pot...
| Publicado en: | Journal of the Peripheral Nervous System Vol. 23; no. 2; pp. 78 - 88 |
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| Autores principales: | , , , , |
| Formato: | algorithm pictorial review tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Jun2018
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=130185591&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 130185591 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10859489 HYG jtl: Journal of the Peripheral Nervous System issn: 10859489 maglogo: Y pubinfo: dt: Jun2018 vid: 23 iid: 2 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 130185591 130185591 130185591 10.1111/jns.12262 130185591 ppf: 78 ppct: 10 formats: tig: atl: Individualized immunoglobulin therapy in chronic immune‐mediated peripheral neuropathies. aug: au: Allen, Jeffrey A. Berger, Melvin Querol, Luis Kuitwaard, Krista Hadden, Robert D. affil: Department of Neurology, University of Minnesota, Minneapolis, MN, USA sug: subj: Individualized Medicine Immunoglobulins Therapeutic Use Peripheral Nervous System Diseases Drug Therapy Autoantibodies Blood Peripheral Nervous System Diseases Diagnosis Immunoglobulins Pharmacokinetics Immunoglobulins Metabolism Treatment Outcomes Clinical Assessment Tools Outcome Assessment ab: Abstract: Despite the well‐recognized importance of immunoglobulin therapy individualization during the treatment of chronic inflammatory demyelinating polyneuropathy (CIDP), the pathway to best achieve optimization is unknown. There are many pharmacokinetic and immunobiologic variables that can potentially influence the appropriateness of any individual therapy. Although identification of specific autoantibodies and their targets has only been accomplished in a minority of patients with CIDP, already the diagnostic and treatment implications of specific autoantibody detection are being realized. Individual variability in IgG pharmacokinetic properties including IgG catabolic rates and distribution, as well as the IgG level necessary for disease control also require consideration during the optimization process. For optimization to be successful there must be a measure of treatment response that has a clinically meaningful interpretation. There are currently available well‐defined and validated clinical assessment tools and outcome measures that are well suited for this purpose. While there remains much to learn on how best to manipulate immunopathology and immunoglobulin pharmacokinetics in the most favorable way, there currently exists an understanding of these principles to a degree sufficient to begin to develop rational and evidence‐based treatment optimization strategies. pubtype: Academic Journal doctype: algorithm pictorial review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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