A nationwide retrospective analysis on the effect of immune therapies in patients with chronic inflammatory demyelinating polyradiculoneuropathy
Article first published online: 23 OCT 2009
© 2009 The Author(s). Journal compilation © 2009 EFNS
European Journal of Neurology
Volume 17, Issue 2, pages 289–294, February 2010
How to Cite
Cocito, D., Paolasso, I., Antonini, G., Benedetti, L., Briani, C., Comi, C., Fazio, R., Jann, S., Matà, S., Mazzeo, A., Sabatelli, M., Nobile-Orazio, E. and on behalf of The Italian Network for CIDP Register (2010), A nationwide retrospective analysis on the effect of immune therapies in patients with chronic inflammatory demyelinating polyradiculoneuropathy. European Journal of Neurology, 17: 289–294. doi: 10.1111/j.1468-1331.2009.02802.x
- Issue published online: 13 JAN 2010
- Article first published online: 23 OCT 2009
- Received 13 April 2009 Accepted 10 August 2009
- chronic inflammatory demyelinating polyneuropathy;
- immunosuppressant drugs;
- plasma exchange;
Background and purpose: The guidelines for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) therapy suggest to use immunoglobulins (IVIg) and steroid as first-line therapies. Patients who do not respond to one of the two drugs should be switched to the other drug. We collected therapeutic outcome data in patients followed at 11 centres in order to document the clinical practice in Italy.
Methods: Clinical and electrophysiological data of patients with CIDP were entered into a central database. The clinical outcome (Rankin Scale) and drug side effects (SE) for first- and second-line therapies were recorded.
Results: A total of 267 patients were included. The percentage of responders (R) to first-line therapy [steroid or IVIg or plasma exchange (PE)] was 69%; this number increased to 81% when patients who switched to different therapies were included. Overall, the percentage of R to IVIg was similar to R to steroids (P = 0.07) and higher than R to PE (P < 0.001). Of the main therapies, PE frequently caused SE (19%), followed by steroids (12.5%) and IVIg (4%).
Conclusions: Switching between traditional therapies increases the number of responder patients. IVIg was confirmed to be a therapy with low SE.