High-dose intravenous immunoglobulin is effective diabetic polyneuropathy resistant to conventional treatments. Results of a double-blind, randomized, placebo-controlled trial: comments

Abstract

We read with interest a recent publication by Jann et al., “High-Dose Intravenous Immunoglobulin Is Effective Diabetic Polyneuropathy Resistant to Conventional Treatments. Results of a Double-Blind, Randomized, Placebo-Controlled Trial” [1]. The results suggest intravenous immunoglobulin (IVIG) as a promising pain treatment modality for this group of patients.

Although the study methodology has provided a detailed outline of its population recruitment, there was no information regarding the severity of diabetes and diabetic control, in terms of micro- and macrovascular complications and HbA1c levels. Better glycemic control is known to reduce the incidence of clinical neuropathy, although its impact on pain is unknown [2]. Nevertheless, improvement in diabetic control during the course of the study remains a potential confounder and may have an influence on the symptoms of DPN.