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IVIg trial for POTS – results out

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Results are out for the first proper randomised controlled trial of IVIg for POTS!


When I read about this trial, which has IVIg as the active drug and IV albumin as the placebo, I *said* that they might find that everyone felt better because albumin also has immunomodulatory properties.

And that is possibly what they found. Hire me as your assistant, Dr Vernino!


(The other possibility is that albumin boosted blood volume with a longer “sticking time” than saline. Or maybe it boosted blood volume and had an immune modulating effect as well.)

Albumin has its risks, like any blood product, but it is waaaaaay cheaper than IVIg.

Specialists in Canada have been using it for severe treatment refractory POTS patients for years:


(I do wish those Canadian specialists would publish some case studies at the very least.)

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Found a link to the prepress version (PDF):


I have had a quick read. They didn’t quite get the results they expected from the IVIg group, but they seem to have learned a lot and paved the way for further study. Yay!

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I did not read the whole article but were the trial folks confirmed as to having any autoimmune issues? I agree albumin would be cheaper but in my eyes don't see the medical community here in the states wanting to treat with it just like with blood during surgeries and what not unless it is absolutely needed.   

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@MikeO, yes, they tried to select POTS patients who had autoimmune features.

There was supposed to be a big trial of IV albumin for POTS in Canada, but unfortunately it was cancelled.

You are right, this one won’t lead to anyone getting albumin or IVIg, but it paves the way for bigger studies. I believe they call it a pilot study.

Gotta start somewhere – this is the first proper trial of IVIg for POTS, and in a way it is also the first proper trial of IV albumin for POTS even though it was supposed to be the placebo.

Now the researchers can say to funding bodies:

”We got these interesting results. Can we have some more money to take it further?”

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