Multifocal motor neuropathy, or MMN, is an immune-mediated disorder, which causes muscle weakness that worsens over time.1 MMN commonly begins in the finger, thumb, wrist or lower leg.2,4 It affects the strength in the lower parts of the arms and hands more than the legs, usually without affecting touch sensation.1

It is thought that with MMN, the immune system abnormalities affect a protective layer (myelin sheath) around nerve cells that control muscle function. The protective layer normally allows messages to be sent properly and quickly along the nervous system. When the protective layer breaks down, nerve damage can occur. When messages are interrupted, muscle weakness can occur.3,4

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MMN is a rare, often difficult to diagnose disorder. Some symptoms of MMN are similar to those of other types of nerve disorders.6 The diagnosis of MMN often is based on a physical exam, an evaluation of symptoms, an electromyography (EMG) test, nerve conduction study, laboratory tests, MRI, and medical history.3,6

Your healthcare provider may also request a blood test or order other tests to fully understand your health status.3,6

While the exact cause of MMN is unknown, it is thought that immune system abnormalities affect a protective layer around nerve cells that control muscle function. In a normal nerve, the protective layer (myelin sheath) allows messages to be sent properly and quickly along the nervous system (Figure 1). When the protective layer (myelin sheath) breaks down, nerve damage can occur (Figure 2). When messages are interrupted, muscle weakness can occur.3,4

Figure 1: Normal nerve

Figure 2: Damaged nerve

What it is

  • Chronic, treatable, but incurable immune-mediated disorder that affects nerves and muscles5
  • Associated with muscle weakness that can interfere with daily living3,8
  • Rare, often difficult to diagnose condition5

What it is not

  • Fatal3
  • Amyotrophic lateral sclerosis (ALS) or Lou Gehrig's disease3
  • A nerve compression condition, such as carpal tunnel sydrome6

GAMMAGARD LIQUID [Immune Globulin Infusion (Human)] 10% is made from human plasma that is donated by healthy people. GAMMAGARD LIQUID contains antibodies collected from these healthy people. The role of these antibodies and the mechanisms of action of IgG in GAMMAGARD LIQUID in the treatment of MMN is not fully understood.1

GAMMAGARD LIQUID is also used to treat adult patients with Multifocal Motor Neuropathy (MMN), a rare disease that causes muscle weakness that worsens over time.

Stop the infusion immediately and contact your healthcare provider or call emergency services if you have any of the following:

Symptoms of thrombosis (blood clots) that may include: pain and/or swelling of an arm or leg with warmth over the affected area, discoloration (redness) or lump in an arm or leg, unexplained shortness of breath, chest pain or discomfort that worsens on deep breathing, unexplained rapid pulse, numbness or weakness on one side of the body.

Symptoms of a kidney problem that may include: reduced urination, sudden weight gain or swelling in your legs.

Symptoms of a serious allergic reaction that may include: hives, skin rash, itching, swelling in the mouth or throat, trouble breathing, wheezing, fainting or dizziness.

Other serious symptoms including: bad headache with nausea, vomiting, stiff neck, drowsiness, fever, sensitivity to light, painful eye movements; blurred vision; brown or red urine, fast heart rate, yellow skin or eyes; trouble breathing, blue lips or extremities; fever over 100°F.

Tell your healthcare provider if you have a history of thrombosis (blood clots), thrombotic events, poor kidney function or kidney failure.

Do not use GAMMAGARD LIQUID if you have a known history of a severe allergic reaction to immune globulin or other blood products. If you have such a history, discuss this with your healthcare provider to determine if GAMMAGARD LIQUID can be given to you. Tell your healthcare provider if you have a condition called selective (or severe) immunoglobulin A deficiency.

GAMMAGARD LIQUID is made from human blood. It may contain infectious agents that can cause disease e.g., viruses, the variant Creutzfeldt-Jakob disease (vCJD), and theoretically, the Creutzfeldt-Jakob disease agent. Patients should report any symptoms that concern them which might be caused by virus infections.

GAMMAGARD LIQUID can make vaccines (e.g., measles, mumps, rubella, or chicken pox vaccines) not work as well. It may also affect your blood test results. Before you get any vaccines or have your blood tested, tell your healthcare provider that you take GAMMAGARD LIQUID.

The following is a list of common side effects seen in clinical trials of GAMMAGARD LIQUID:

MMN (IV administration): Headache, chest discomfort, muscle spasms, muscular weakness, nausea, sore throat, ear pain, and pain in extremity.

Although it is possible to receive IV infusions at home, they are more often given in a hospital or infusion center by a nurse. Whenever giving yourself treatments at home, you should have another responsible person present to help treat side effects or get help should a serious adverse reaction occur. Ask your healthcare provider whether you should have rescue medications, such as antihistamines or epinephrine.

Please see the full Prescribing Information, including the Patient Product Information.

You may report side effects to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

You may report side effects to Shire Drug Safety at 1-800-999-1785 or drugsafety.us@baxalta.com.

If you have a medical question regarding the use of GAMMAGARD LIQUID, please ask your healthcare provider.

References:

  1. Gammagard Liquid [Immune Globulin Infusion (Human)] 10% [package insert]. Westlake Village, CA: Baxter Healthcare Corp.
  2. Slee M, Selvan A, Donaghy M. Multifocal motor neuropathy: the diagnostic spectrum and response to treatment. Neurology. 2007;69:1680-1687.
  3. Vlam L, Van der Pol WL, Cats EA, et al. Multifocal motor neuropathy: diagnosis, pathogenesis and treatment strategies. Nat Rev Neurol. 2012;8:48-58.
  4. Piepers S, Jansen MD, Cats EA, van Sorge NM, van den Berg LH, van der Pol WL. IVIg inhibits classical pathway activity and anti-GM1 IgM-mediated complement deposition in MMN. J Neuroimmunol. 2010;229(1-2):256-262.
  5. Harati Y, Bosch EP. Disorders of the Peripheral Nerves. In: Bradley WG, Daroff RB, Fenichel G, Jankovic J, eds. Bradley's Neurology in Clinical Practice: Expert Consult. Philadelphia, PA: Elsevier Saunders; 2008.
  6. Meuth SG, Kleinschnitz C. Multifocal motor neuropathy: update on clinical characteristics, pathophysiological concepts and therapeutic options. Eur Neurol. 2010;63:193-204.
  7. Shy ME. Peripheral neuropathies. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine, 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:2396-2409.
  8. Sharrack B, Hughes RA. The Guy's Neurological Disability Scale (GNDS): a new disability measure for multiple sclerosis. Multiple sclerosis. 1999;5(4):223-233.

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