Monoclonal Gammopathies of Undetermined Significance (MGUS) Medication

Updated: Aug 03, 2023
  • Author: Suzanne R Fanning, DO; Chief Editor: Emmanuel C Besa, MD  more...
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Medication Summary

No treatment is recommended for patients with uncomplicated monoclonal gammopathy of undetermined significance (MGUS). Treatment recommendations for patients with monoclonal gammopathy of clinical significance (ie, those with signs and symptoms referable to nerves, kidneys, and/or skin) are largely anecdotal. [7, 6] However, in patients with monoclonal gammopathy of renal significance (MGRS), management follows the treatment algorithm for multiple myeloma in cases of non‐IgM– and free light chain–associated MGRS, and follows that for Waldenström macroglobulinemia in cases of IgM‐associated MGRS. [7]

For several of the neurologic and dermatologic conditions, intravenous immunoglobulin, rituximab, and plasma cell–directed therapy have shown benefit. [6] For example, a prospective open-label trial by Niermeijer et al in 17 patients with IgM MGUS polyneuropathy found that treatment with rituximab was associated with improvement in three impairment measures, and no serious adverse events. [54]