Intravenous immunoglobulins for Alzheimer’s disease and mild cognitive impairment due to Alzheimer’s disease: A systematic review with meta-analysis

ABSTRACT

Introduction: Alzheimer’s disease (AD) is the most common phenotype of dementia. Mild cognitive impairment (MCI) due to AD is believed as a prodromal stage of AD. Intravenous immunoglobulin (IVIG) is a classical immunotherapy and potentially reduces AD-type pathology by anti-Aβ, anti-tau, anti-inflammatory effects, and non-antibody-mediated effects.

Areas covered: The authors aimed to determine the efficacy and safety of IVIG for AD and MCI due to AD patients. The electronic databases including PubMed, EMBASE, CINAHL, Cochrane Library, and China National Knowledge Infrastructure were searched until March 2019. The results were pooled via a random-effects model. There were five eligible studies with 772 randomized patients with AD and MCI due to AD, which compared IVIG with placebo.

Expert opinion: No significant differences were found in the scores of mini–mental state examination and Alzheimer’s disease assessment scale-cognitive subscale and number of patients with adverse events. IVIG is well tolerated in the patients with AD and MCI due to AD, even in long-term therapy for 18 months. Insufficient evidences support IVIG in the treatment of patients with AD and MCI due to AD to improve cognition or disease modification. Well-designed randomized controlled trials with large sample sizes are required in the future.

KEYWORDS:

• Intravenous immunoglobulins
• systematic review
• meta-analysis
• Alzheimer’s disease
• mild cognitive impairment due to Alzheimer’s disease

Article highlights

• The authors aimed to determine the efficacy and safety of IVIG for patients with AD and MCI due to AD.

• According to the inclusion criteria, five studies were included with 772 randomized patients.

• IVIG is well tolerated in the patients with AD and MCI due to AD, even in long-term therapy for 18 months.

• Insufficient evidences support IVIG in the treatment of patients with AD and MCI due to AD to improve cognition or disease modification.

• Well-designed randomized controlled trials with large sample sizes are required in the future.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

A reviewer on this manuscript works at an institution which holds a patent on autoantibodies in the treatment of neurodegenerative disorders. Peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.

Additional information

Funding

This paper was not funded.