Observational studyJournal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine2017
Intravenous Immunoglobulin Therapy in Pediatric Narcolepsy: A Nonrandomized, Open-Label, Controlled, Longitudinal Observational Study.
Observational study in Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 45 citations in OpenAlex.
- Treatment of central disorders of hypersomnolence: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2021Pooled it
- A Comprehensive Review of Current and Emerging Treatments for Narcolepsy Type 1.Journal of clinical medicine · 2025Review
- Ofatumumab treatment in new-onset narcolepsy type 1 following SARS-CoV-2 infection.Annals of clinical and translational neurology · 2025Article
- Development of the pediatric narcolepsy patient-reported outcomes scale (PN-PROs).Frontiers in sleep · 2024Article
- Central hypersomnia and chronic insomnia: expanding the spectrum of sleep disorders in long COVID syndrome - a prospective cohort study.BMC neurology · 2022Article
- Pediatric Narcolepsy-A Practical Review.Children (Basel, Switzerland) · 2022Review
- Intravenous immunoglobulin induces IgG internalization by tolerogenic myeloid dendritic cells that secrete IL-10 and expand Fc-specific regulatory T cells.Clinical and experimental immunology · 2022Article
- Update on Intravenous Immunoglobulin in Neurology: Modulating Neuro-autoimmunity, Evolving Factors on Efficacy and Dosing and Challenges on Stopping Chronic IVIg Therapy.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2021Review
- IgG Epitopes Processed and Presented by IgGJournal of immunology (Baltimore, Md. : 1950) · 2021Observational
- Treatment with immune modulators in a child with recent-onset type 1 narcolepsy.Sleep & breathing = Schlaf & Atmung · 2021Article
- Reviewing the Clinical Implications of Treating Narcolepsy as an Autoimmune Disorder.Nature and science of sleep · 2021Review
- A practical guide to the pharmacological and behavioral therapy of Narcolepsy.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2021Review
- Immunotherapy in Narcolepsy.Current treatment options in neurology · 2020Review
- Recent advances in treatment for narcolepsy.Therapeutic advances in neurological disorders · 2019Review
- Narcolepsy Associated with Pandemrix Vaccine.Current neurology and neuroscience reports · 2018Review
- Intravenous Immunoglobulin Therapy Administered Early after Narcolepsy Type 1 Onset in Three Patients Evaluated by Clinical and Polysomnographic Follow-Up.Behavioural neurology · 2018Article
- Narcolepsy Type 1 as an Autoimmune Disorder: Evidence, and Implications for Pharmacological Treatment.CNS drugs · 2017Review
- Cataplexy and Its Mimics: Clinical Recognition and Management.Current treatment options in neurology · 2017Review
- Is it Time for Immunotherapy Trials in Narcolepsy?Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2017Article
Corrections and comments
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Authors and funding
6 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
objectivesPrevious case reports of intravenous immunoglobulins (IVIg) in pediatric narcolepsy have shown contradictory results.
methodsThis was a nonrandomized, open-label, controlled, longitudinal observational study of IVIg use in pediatric narcolepsy with retrospective data collection from medical files obtained from a single pediatric national reference center for the treatment of narcolepsy in France. Of 56 consecutively referred patients with narcolepsy, 24 received IVIg (3 infusions administered at 1-mo intervals) in addition to standard care (psychostimulants and/or anticataplectic agents), and 32 continued on standard care alone (controls).
resultsFor two patients in each group, medical files were unavailable. Of the 22 IVIg patients, all had cerebrospinal fluid (CSF) hypocretin ≤ 110 pg/mL and were HLA-DQB1*06:02 positive. Of the 30 control patients, 29 were HLA-DQB1*06:02 positive and of those with available CSF measurements, all 12 had hypocretin ≤ 110 pg/mL. Compared with control patients, IVIg patients had shorter disease duration, shorter latency to sleep onset, and more had received H1N1 vaccination. Mean (standard deviation) follow-up length was 2.4 (1.1) y in the IVIg group and 3.9 (1.7) y in controls. In multivariate-adjusted linear mixed-effects analyses of change from baseline in Ullanlinna Narcolepsy Scale (UNS) scores, high baseline UNS, but not IVIg treatment, was associated with a reduction in narcolepsy symptoms. On time-to-event analysis, among patients with high baseline UNS scores, control patients achieved a UNS score < 14 (indicating remission) less rapidly than IVIg patients (adjusted hazard ratio 0.18; 95% confidence interval: 95% confidence interval: 0.03, 0.95; p = 0.043). Shorter or longer disease duration did not influence treatment response in any analysis.
conclusionsOverall, narcolepsy symptoms were not significantly reduced by IVIg. However, in patients with high baseline symptoms, a subset of IVIg-treated patients achieved remission more rapidly than control patients. COMMENTARY: A commentary on this article appears in this issue on page 363.
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