Electrophysiology in chronic inflammatory demyelinating polyneuropathy with IGIV.
Patients with chronic inflammatory demyelinating polyneuropathy (CIDP) received immune globulin intravenous, 10% caprylate/chromatography purified (IGIV-C, Gamunex; n=59) or placebo (n=58) every 3 weeks for up to 24 weeks (first period) in a randomized, double-blind, parallel-group, response-conditional, crossover study. Motor and sensory nerves were assessed at baseline and endpoint/week 24. A nonsignificant trend toward improvement in the proximal amplitude of the most severely affected motor nerve was observed with IGIV-C (0.69+/-1.86 mV) versus placebo (0.47+/-2.29 mV), and a greater improvement of 1.08+/-2.15 mV with IGIV-C versus 0.46+/-2.03 mV with placebo (P=0.089) was observed with exclusion of data from Erb's point stimulation. Greater improvements from baseline favoring IGIV-C were observed for 127/142 electrophysiologic parameters. The averaged motor amplitudes from all motor nerves significantly improved with IGIV-C versus placebo [treatment difference, 0.62 mV; 95% confidence interval (CI), 0.05, 1.20; P=0.035], and conduction block decreased significantly (treatment difference, -5.54%; 95% CI, -10.43, -0.64; P=0.027), particularly in the lower limbs. Overall, the data suggest that IGIV-C improves electrophysiologic parameters in CIDP.
Bril
Vera
V
Department of Neurology, University Health Network, Toronto, Ontario, Canada. vera.bril@utoronto.ca
Katzberg
Hans
H
Donofrio
Peter
P
Banach
Marta
M
Dalakas
Marinos C
MC
Deng
Chunqin
C
Hanna
Kim
K
Hartung
Hans-Peter
HP
Hughes
Richard A C
RA
Latov
Norman
N
Merkies
Ingemar S J
IS
van Doorn
Pieter A
PA
D000200:Action Potentials / Q000187:drug effects* / Q000502:physiology; D001132:Arm / Q000294:innervation; D002210:Caprylates; D002845:Chromatography / Q000379:methods; D018592:Cross-Over Studies; D004568:Electrodiagnosis; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage* / Q000302:isolation & purification; D007155:Immunologic Factors / Q000008:administration & dosage* / Q000302:isolation & purification; D007866:Leg / Q000294:innervation; D009046:Motor Neurons / Q000187:drug effects / Q000502:physiology; D009431:Neural Conduction / Q000187:drug effects* / Q000502:physiology; D010919:Placebos; D020277:Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology*; D016896:Treatment Outcome
D002210:Caprylates; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors; D010919:Placebos