title: Chronic inflammatory demyelinating polyradiculoneuropathy: search for factors associated with treatment dependence or successful withdrawal.
abstract: BACKGROUND
  About 40% of responders to treatment for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) remain treatment dependent and have a relapse if treatment is interrupted.
  
  
  OBJECTIVE
  To look for factors associated with treatment dependence or successful withdrawal in CIDP patients.
  
  
  METHODS
  We retrospectively studied 70 responder CIDP patients comprising 34 patients who remained treatment dependent (treatment-dependent group) and 36 patients whose treatment could be discontinued (treatment withdrawal group). Clinical, biological, electrophysiological and therapeutic features were compared between these groups.
  
  
  RESULTS
  A multifocal deficit was more frequent in the treatment-dependent group (35%) than in the treatment withdrawal group (8%) (p<0.01). The most frequent effective treatment was intravenous immunoglobulin (IVIG) for the treatment-dependent group (79%). In this group, more patients were resistant to corticosteroids in first-line therapy (93%) than in the treatment withdrawal group (40%) (p=0.002). The delay to effective treatment was significantly shorter for the treatment withdrawal group than for the treatment-dependent group (mean 11.1 vs 31.2 months; p<0.01). The rate of successful withdrawal was lower with IVIG (29%) than with corticosteroids (83%) (p<0.001).
  
  
  CONCLUSIONS
  When compared with the treatment withdrawal group, the treatment-dependent group was more frequently responsive to IVIG, more frequently resistant to corticosteroids in first-line treatment, had a longer delay to effective treatment and was more likely to present a multifocal deficit. The rate of successful withdrawal seems to be higher with corticosteroids, but a prospective study with a long-term follow-up is needed to confirm these features.
authors.affiliation: Département de Neurophysiologie Clinique, Groupe Hospitalier Pitié-Salpêtrière Paris, Université Pierre et Marie Curie-Paris VI, AP-HP, Paris, France.
authors.forename: Magalie
authors.initials: M
authors.lastname: Rabin
authors.affiliation: Groupe Hospitalier Pitié-Salpêtrière Paris, Service d'urgence cérébrovasculaire Université Pierre et Marie Curie-Paris VI, AP-HP, Paris, France.
authors.forename: Gurkam
authors.initials: G
authors.lastname: Mutlu
authors.affiliation: Département de Neurophysiologie Clinique, Groupe Hospitalier Pitié-Salpêtrière Paris, Université Pierre et Marie Curie-Paris VI, AP-HP, Paris, France Groupe Hospitalier Pitié-Salpêtrière Paris, Centre de Référence des Pathologies Neuromusculaires Paris Est, Université Pierre et Marie Curie-Paris VI, AP-HP, Paris, France.
authors.forename: Tanya
authors.initials: T
authors.lastname: Stojkovic
authors.affiliation: Département de Neurophysiologie Clinique, Groupe Hospitalier Pitié-Salpêtrière Paris, Université Pierre et Marie Curie-Paris VI, AP-HP, Paris, France Centre diagnostique et thérapeutique des neuropathies périphériques, Département de Neurophysiologie et Service de Neurologie 1, Groupe Hospitalier Pitié-Salpêtriére Paris, Université Pierre et Marie Curie-Paris VI, AP-HP, Paris, France Département de Neuropathologie R Escourolle, Groupe Hospitalier Pitié-Salpêtrière Paris, Université Pierre et Marie Curie-Paris VI, AP-HP, Paris, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Maisonobe
authors.affiliation: Département de Neurophysiologie Clinique, Groupe Hospitalier Pitié-Salpêtrière Paris, Université Pierre et Marie Curie-Paris VI, AP-HP, Paris, France Centre diagnostique et thérapeutique des neuropathies périphériques, Département de Neurophysiologie et Service de Neurologie 1, Groupe Hospitalier Pitié-Salpêtriére Paris, Université Pierre et Marie Curie-Paris VI, AP-HP, Paris, France.
authors.forename: Timothée
authors.initials: T
authors.lastname: Lenglet
authors.affiliation: Département de Neurophysiologie Clinique, Groupe Hospitalier Pitié-Salpêtrière Paris, Université Pierre et Marie Curie-Paris VI, AP-HP, Paris, France Groupe Hospitalier Pitié-Salpêtrière Paris, Centre de Référence des Pathologies Neuromusculaires Paris Est, Université Pierre et Marie Curie-Paris VI, AP-HP, Paris, France Centre diagnostique et thérapeutique des neuropathies périphériques, Département de Neurophysiologie et Service de Neurologie 1, Groupe Hospitalier Pitié-Salpêtriére Paris, Université Pierre et Marie Curie-Paris VI, AP-HP, Paris, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Fournier
authors.affiliation: Département de Neurophysiologie Clinique, Groupe Hospitalier Pitié-Salpêtrière Paris, Université Pierre et Marie Curie-Paris VI, AP-HP, Paris, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Bouche
authors.affiliation: Groupe Hospitalier Pitié-Salpêtrière Paris, Centre de Référence des Pathologies Neuromusculaires Paris Est, Université Pierre et Marie Curie-Paris VI, AP-HP, Paris, France.
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Léger
authors.affiliation: Département de Neurophysiologie Clinique, Groupe Hospitalier Pitié-Salpêtrière Paris, Université Pierre et Marie Curie-Paris VI, AP-HP, Paris, France Centre diagnostique et thérapeutique des neuropathies périphériques, Département de Neurophysiologie et Service de Neurologie 1, Groupe Hospitalier Pitié-Salpêtriére Paris, Université Pierre et Marie Curie-Paris VI, AP-HP, Paris, France.
authors.forename: Karine
authors.initials: K
authors.lastname: Viala
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000367:Age Factors; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D018450:Disease Progression; D004568:Electrodiagnosis; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020277:Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / Q000628:therapy*; D012008:Recurrence; D012189:Retrospective Studies; D012737:Sex Factors; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D016756:Immunoglobulins, Intravenous
keywords: NEUROPATHY