IqYmune® is an effective maintenance treatment for multifocal motor neuropathy: A randomised, double-blind, multi-center cross-over non-inferiority study vs Kiovig®—The LIME Study

Intravenous immunoglobulin (IVIg) is the gold-standard for maintenance treatment of multifocal motor neuropathy (MMN). This phase III, randomised, double-blind, multi-centre, active-control, crossover study, aimed to evaluate the non-inferiority of IqYmune\uae relative to Kiovig\uae, primarily based on efficacy criteria. Twenty-two adult MMN patients, treated with any brand of IVIg (except Kiovig\uae or IqYmune\uae) at a stable maintenance dose within the range of 1 to 2 g/kg every 4 to 8 weeks, were randomised to receive either Kiovig\uae followed by IqYmune\uae, or IqYmune\uae followed by Kiovig\uae. Each product was administered for 24 weeks. The primary endpoint was the difference between IqYmune\uae and Kiovig\uae in mean assessments of modified Medical Research Council (MMRC) 10 sum score (strength of 5 upper-limb and 5 lower-limb muscle groups, on both sides, giving a score from 0 to 100) during the evaluation period (non-inferiority margin of \u394 = 2). A linear mixed model analysis demonstrated the non-inferiority of IqYmune\uae relative to Kiovig\uae, independently of the covariates (value at baseline, treatment period, and treatment sequence). The estimated \u201cIqYmune\uae 12 Kiovig\uae\u201d difference was 120.01, with a 95% confidence interval (CI) 120.51 to 0.48. The number of adverse reactions (ARs) and the percentage of patients affected were similar for the two products: 39 ARs in 10 patients with IqYmune\uae vs 32 ARs in 11 patients with Kiovig\uae. No thromboembolic events nor haemolysis nor renal impairment were observed. In this first clinical trial comparing two IVIg brands for maintenance treatment of MMN, efficacy and tolerability of both brands were similar