To report SUSPECTED ADVERSE REACTIONS, contact argenx at 1-833-argx411 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch
Resource Library
To report SUSPECTED ADVERSE REACTIONS, contact argenx at 1-833-argx411 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch
To report SUSPECTED ADVERSE REACTIONS, contact argenx at 1-833-argx411 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch
Managing MMN
Examine current approaches to managing MMN
Unmet needs in MMN MDT management
Current therapeutic landscape in MMN
Therapeutic options are currently limited. While there is no cure for MMN, symptoms can be stabilized.1
IVIg and SCIg have been shown to be effective in MMN treatment,2,3 although only IVIg has been approved for its treatment in the US and Europe. 4-7
A Cochrane meta-analysis of six RCTs including 90 randomized participants with MMN suggested that:
- More participants experienced an improvement in disability following induction IVIg treatment than those treated with placebo:2,a–f
of participants treated with IVIg experienced muscle strength improvement, compared with 4% of placebo-treated participants
of participants treated with IVIg experienced disability improvement, compared with 11% of placebo-treated participants
Study limitations: The meta-analysis deemed this evidence to be of low certainty due to a small sample size, wide estimated confidence intervals, and low statistical power. Additionally, none of the included trials assessed the number of participants with sustained disability improvement at 12 months.2
Considerations for IVIg treatment in MMN
While IVIg has been shown to improve disability in patients with MMN, most require long-term maintenance therapy with IVIg to prevent clinical deterioration. Additionally, the following factors should be considered:2,8
A proportion of patients may continue to experience disease progression and loss of muscle strength, even with ongoing IVIg treatment8,9
Some studies suggest that conduction block may persist despite clinical improvement8,10
For most patients, the dosage of IVIg required to maintain clinical response increases over time8,9
IVIg is associated with mild to moderate adverse events, such as headache, rash, and fatigue, as well as less frequent severe events, including thromboembolic complications and severe erythema9,10
Footnotes:
aAll studies used a crossover design.2
bAzulay et al. examined five participants with MMN. Participants were 80% male and had a mean (range) age of 42.1 (19–63) years. Muscle strength was evaluated using a computerized analyzer. Disability was assessed using the derived Norris scale.14
cFederico et al. enrolled 16 participants with MMN. Participants were 94% male and had a mean (range) age of 38.9 (36.1–41.7) years. Disability was measured using a quantitative neurologic disability scale and muscle strength was assessed using grip strength measurements.15
dHahn et al. enrolled 44 participants with MMN. Participants were 72.7% male and had a mean (SD) age at time of consent of 51.64 (10.25) years. Muscle strength was evaluated using grip strength measurements and disability was measured using Guy’s Neurological Disability Score.16
eLeger et al. enrolled 19 participants with MMN. Participants were 68.4% male and had a mean (SD) age of 51.9 (6.8) years in the placebo group and 57.1 (6.6) years in the IVIg treatment group. Muscle strength was evaluated using the MRC score.17
fVan den Berg et al. enrolled six participants with MMN. Participants were 66.7% male with ages ranging from 33 to 64 years. Muscle strength was evaluated using the MRC scale and disability was measured using the modified Rankin scale.18
Abbreviations:
IVIg=intravenous immunoglobulin; MDT=multidisciplinary team; MMN=multifocal motor neuropathy; MRC=Medical Research Council; RCT=randomized controlled trial; SCIg=subcutaneous immunoglobulin; SD=standard deviation.
References:
1. Joint Task Force of the EFNS PNS. J Peripher Nerv Syst. 2010:295–301. doi:10.1111/j.1529-8027.2010.00290.x; 2. Keddie S, et al. Cochrane Database Syst Rev. 2022;1(1):CD004429. doi:10.1002/14651858.CD004429.pub3; 3. Gentile L, et al. Sci Rep. 2021;11:9216. doi:10.1038/s41598-021-88711-9; 4. CSL Behring. HYQVIA. Prescribing Information. July 2025. Available at: https://www.fda.gov/media/89844/download?attachment (Accessed: March 2026); 5. CSL Behring. HYQVIA. EU Summary of Product Characteristics. August 2025. Available at: https://www.ema.europa.eu/en/documents/product-information/hyqvia-epar-product-information_en.pdf (Accessed: March 2026); 6. CSL Behring. Hizentra. EU Summary of Product Characteristics. December 2025. Available at: https://www.ema.europa.eu/en/documents/product-information/hizentra-epar-product-information_en.pdf (Accessed: March 2026); 7. CSL Behring. CUVITRU. Prescribing Information. September 2021. Available at: https://www.fda.gov/media/100531/download (Accessed: March 2026); 8. Yeh WZ, et al. J Neurol Neurosurg Psychiatry. 2020;91:140–148. doi:10.1136/jnnp-2019-321532; 9. Cats EA, et al. Neurology. 2010;75(22):1961–1967. doi:10.1212/WNL.0b013e3181ff94c2; 10. Van den Berg-Vos, RM. et al. Brain. 2002;125:1875–1886. doi:10.1007/s00415-003-0235-9;
11. Li Z, et al. Front Neurol. 2024;15:1478419. doi:10.3389/fneur.2024.1478419; 12. Umpathi T, et al. Cochrane Database Syst Rev. 2015(3):CD003217. doi:10.1002/14651858.CD003217.pub5; 13. van Schaik IN, et al. Cochrane Database Syst Rev. 2005(2):CD004429. doi:10.1002/14651858.CD004429.pub2; 14. Azulay JP, et al. Neurol. 1994;44:429–432. doi:10.1212/wnl.44.3_part_1.429; 15. Federico P, et al. Neurol. 2000;55:1256–1262. doi:10.1212/wnl.55.9.1256; 16. Hahn AF, et al. J Periph Nerv Syst. 2013;18:321–330. doi:10.1111/jns5.12046; 17. Leger JM, et al. Brain. 2001;124(1):145–153. doi:10.1093/brain/124.1.145; 18. Van den Berg LH, et al. J Neurol Neurosurg Psychiatry. 1995;59(3):248–252. doi:10.1136/jnnp.59.3.248.
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