Evaluation of Intravenous Immunoglobulin in Pediatric Acute-Onset Neuropsychiatric Syndrome
RESEARCH IMPACT:
“Evaluation of Intravenous Immunoglobulin in Pediatric Acute-Onset Neuropsychiatric Syndrome” showed that IVIG therapy significantly reduced neuropsychiatric symptoms in PANS patients, with sustained benefits in many cases, confirming immune system involvement in the disorder. Findings support the autoimmune basis of PANS, highlighting IVIG as a promising long-term immunomodulatory treatment. This study adds to growing evidence that PANS is an autoimmune disorder, reinforcing the role of immune-targeted therapies in its management.
SUMMARY
“Evaluation of Intravenous Immunoglobulin in Pediatric Acute-Onset Neuropsychiatric Syndrome” researches the efficacy of multiple, consecutive infusions of intravenous immunoglobulin (IVIG) for PANS.
21 children diagnosed with moderate to severe PANS received a unique treatment model of six consecutive IVIG treatments every 21 days over the course of six months. Multiple validated psychometric scales, including the CYBOCS, CGI-S, and YGTSS, and a Parent-Rated PANS Questionnaire (PRPQ) were used to determine outcome measures.
The results demonstrated significant reductions in symptoms across all psychological assessments from baseline to end of treatment and in follow-up visits. Significant symptom drops occurred after the third infusion. During the open label phase of the study, OCD severity scores improved by 50% within 6 weeks. Overall, improvements sustained for at least eight weeks post-treatment and up to 46 weeks in some cases following the final IVIG treatment. According to the authors, “…If PANS were not an autoimmune, autoinflammatory disease, then an immunomodulatory intervention, such as IVIG, should not have any impact on psychometric and clinical measurements.”
The study also found elevated immune and autoimmune markers in most participants, suggesting an underlying immune dysfunction.
Overall, the results highlight the need to research potential immune dysfunction of PANS and the impact IVIG may have on improving patient outcomes.
LINK TO PAPER: https://doi.org/10.1089/cap.2020.0100
CITATION
Melamed, I., Kobayashi, R. H., O’Connor, M., Kobayashi, A. L., Schechterman, A., Heffron, M., Canterberry, S., Miranda, H., & Rashid, N. (2021). Evaluation of Intravenous Immunoglobulin in Pediatric Acute-Onset Neuropsychiatric Syndrome. Journal of child and adolescent psychopharmacology, 31(2), 118–128. https://doi.org/10.1089/cap.2020.0100