Intravenous immunoglobulin treatment of Complex Regional Pain Syndrome: A randomized trial

Goebel, Andreas; Baranowski, Andrew; Maurer, Konrad; Ghiai, Artemis; McCabe, Candy; Ambler, Gareth

Abstract

Background: The treatment of longstanding Complex Regional Pain Syndrome(CRPS) is empirical and often of limited efficacy. Preliminary data suggest that the immune system is involved in sustaining this condition and that treatment with low dose intravenous immunoglobulin may significantly reduce pain in some patients.
Objective: To evaluate intravenous immunoglobulin efficacy in patients with longstanding CRPS under randomized controlled conditions.
Design: A randomized, double-blind, placebo-controlled crossover trial.
Setting: The University College London Hospitals Pain Management Centre.
Patients: We included patients with a pain intensity of > 4 on an 11-point (0-10) numeric rating scale who were refractory to standard treatment and had a disease duration between 6 and 30 months.
Intervention and Measurements: Study participants received 0.5g/kg intravenous immunoglobulin and normal saline in separate treatments divided by a washout period of at least 28 days. The primary outcome was the pain intensity between
days 6-19 after the initial and the crossover treatments.
Results: 13 eligible participants were randomized between November 2005 and May 2008; 12 completed the trial. The average pain intensity after intravenous immunoglobulin treatment was 1.55 units lower than after saline treatment (95% confidence interval: 1.29 to 1.82, p

• Journal Article Type: Article
• Publication Date: Feb 2, 2010
• Journal: Annals of Internal Medicine
• Print ISSN: 0003-4819
• Electronic ISSN: 1539-3704
• Publisher: American College of Physicians
• Peer Reviewed: Peer Reviewed
• Volume: 152
• Issue: 3
• Pages: 152-158
• Keywords: CRPS, Complex Regional Pain Syndrome, intravenous immunoglobulin, IVIG, pain
• Public URL: https://uwe-repository.worktribe.com/output/981399
• Publisher URL: http://www.annals.org/content/152/3/152.short