Treatments that suppress or modify the immune system for multifocal motor neuropathy

Multifocal motor neuropathy is a rare condition causing progressive weakness of the limbs, especially the hands and arms. This disorder is believed to be immunological in nature. The usual treatment is infusion of immunoglobulin (antibodies purified from the blood) into a vein. This is expensive, needs to be repeated every few weeks and is not always completely effective. Immunosuppressive drugs (drugs that suppress immune responses) such as cyclophosphamide, azathioprine, ciclosporin, beta 1a interferon, mycophenolate mofetil and rituximab have been tried as initial or add on treatments. This updated review looked for evidence of the benefits and harms which they produce.  Only one randomised controlled trial, of a drug called mycophenolate mofetil, was found. This medication, when used with immunoglobulin, did not reduce the requirement for immunoglobulin or improve muscle strength of patients with multifocal motor neuropathy. New randomised controlled trials of other immunosuppressive drugs are needed to identify beneficial treatments for multifocal motor neuropathy.