Introduction

This information is for people who have multiple sclerosis. It tells you about immunoglobulin, a treatment used to reduce relapses and disability in multiple sclerosis. It is based on the best and most up-to-date research.

Does it work?

We're not sure. There's not enough evidence to say.

In the UK, you should only be prescribed immunoglobulin by a specialist. Preferably, you should get this medicine as part of a study.^[2] You should have regular checks for side effects. Immunoglobulin is not often used in the UK.

What is it?

Immunoglobulins are proteins made by your immune system. They protect you from infections and diseases.

Immunoglobulins are collected from donated blood. They're separated from other things in the blood and then used as a treatment that can be put into one of your veins once a month if you have MS.

You may hear this treatment called IVIG, which is short for intravenous immunoglobulin. Intravenous means into your vein.

Here are some of the many brand names for immunoglobulin:

• Gammagard

• Sandoglobulin

• Vigam.

How can it help?

If you have the relapsing-remitting type of multiple sclerosis, then treatment with immunoglobulin may reduce how many relapses of MS you have. (For more on the different kinds of MS, see Types of multiple sclerosis.)

In one study, the average number of relapses a year across the group of people taking immunoglobulin was 0.5. This means they had less than one relapse each. People taking a dummy treatment (a placebo) had on average 1.3 (one or two) relapses each in a year.^[47]

In another study, some people who had immunoglobulin over two years saw their level of disability become a bit milder. People who had a placebo had no change in their level of disability.^[48]

However, not all studies show a benefit from immunoglobulin. One big, good-quality study said people were no less likely to have a relapse after a year's treatment with immunoglobulin, than after a year's treatment with a placebo drug.^[49]

Immunoglobulin doesn't seem to help people who have the secondary progressive type of multiple sclerosis.^[50] (If you have relapsing-remitting MS, you have bouts of symptoms that come and go. If you have secondary progressive MS, some of your symptoms stay after a relapse and worsen over time.)

In one study, people who had only one attack of symptoms (their first attack) were treated with immunoglobulin to see if it stopped them getting more attacks in future. Only a quarter of the people who took immunoglobulin had had a relapse a year later, compared with half of those who didn't take immunoglobulin.^[51]

But you are not likely to be offered immunoglobulin if you have had only one attack of symptoms. That's because most people are not diagnosed with MS until they have had at least two attacks. Doctors need to make sure that there aren't other causes for your symptoms.