Therapy

It is now established that intravenous immunoglobulin (IVIg) provides benefit to patients with MMN. IVIg can lead to improvement in most patients with MMN, with the response varying from minimal to very large. The treatment usually does not completely reverse all of the symptoms and those patients who do respond will require repeated treatments to keep their improvements. The exact timing and dosing needs to be individualized and there is no single formula for success. Dosing may need to be adjusted if the response begins to wear off, or if symptoms worsen despite maintenance therapy.

IVIg is not a cure for MMN and currently no other therapy has proven effective. It is fairly clear that corticosteroids are ineffective and can actually make the disease worse. Other immuno­suppressants have been used, but have greater side effects and risks. For example, there are a number of reports suggesting that cyclophosphamide controls the disease in some patients, while results for Rituximab are not encouraging. It is clear that newer therapies are needed, and many investigators around the world are working towards a better understanding of MMN and the development of more definitive treatments.