IVIG to treat complex regional pain syndrome

January 01, 0001

IVIG to treat complex regional pain syndrome

complex regional pain syndrome (CRPS) and that treatment with low- dose intravenous immunoglobulin (IVIG) may substantially reduce pain in some patients. These UK investigators evaluated the efficacy of IVIG (0.5 g/kg) in patients with longstanding CRPS in a randomized, double-blind, placebo- controlled crossover trial. IVIG and normal saline control treatments were separated by at least 28 days. The primary outcome was pain intensity 6 to 19 days after the initial treatment and the crossover treatment.

They found: "13 eligible participants were randomly assigned between November 2005 and May 2008 and 12 completed the trial. The average pain intensity was 1.55 units lower after IVIG treatment than after saline. In 3 patients, pain intensity after IVIG was less than after saline by 50% or more. No serious adverse reactions were reported. The trial was small, and recruitment bias and chance variation could have influenced results and their interpretation."

The authors concluded: "IVIG, 0.5 g/kg, can reduce pain in refractory CRPS. Studies are required to determine the best immunoglobulin dose, the duration of effect, and when repeated treatments are needed."

IVIG seems a reasonable option in these patients with refractory pain.


For the full abstract, click here.

Ann Intern Med 152(3):152-158, 2 February 2010 © 2010 to the American College of Physicians
Intravenous Immunoglobulin Treatment of the Complex Regional Pain Syndrome A Randomized Trial. Andreas Goebel, Andrew Baranowski, Konrad Maurer, et al.

Category: B. Blood/Blood Forming Organs/Immune Mechanisms. Keywords: complex regional pain syndrome, immunoglobulin, randomized controlled trial, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 23 February 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

COVID-19 Resources

WONCA webinars, journal links and more

WONCA position statements

WONCA statements on a variety of issues

PEARLS

577 Individual behavioural counselling helps people to quit smoking 575 Antioxidant vitamin and mineral supplements may be beneficial in age-related macular degeneration 574 Oral antifungals effective for toenail onychomycosis 570 Decision aids beneficial for people facing health treatment or screening decisions 569 Computer-generated reminders on paper benefit quality of care