A nationwide retrospective analysis on the effect of immune therapies in patients with chronic inflammatory demyelinating polyradiculoneuropathy.
OBJECTIVE
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.
Cocito
D
D
Dipartimento di Neuroscienze, AOU San Giovanni Battista, Torino, Italy. dariococito@yahoo.it
Paolasso
I
I
Antonini
G
G
Benedetti
L
L
Briani
C
C
Comi
C
C
Fazio
R
R
Jann
S
S
Matà
S
S
Mazzeo
A
A
Sabatelli
M
M
Nobile-Orazio
E
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000009:adverse effects / Q000627:therapeutic use*; D007155:Immunologic Factors / Q000009:adverse effects / Q000627:therapeutic use*; D007167:Immunotherapy / Q000379:methods; D007558:Italy; D008875:Middle Aged; D010951:Plasma Exchange / Q000009:adverse effects; D020277:Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / Q000188:drug therapy* / Q000503:physiopathology / Q000628:therapy*; D012042:Registries; D012189:Retrospective Studies; D013256:Steroids / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors; D013256:Steroids