title: Measuring disease activity and clinical response during maintenance therapy in CIDP: from ICE trial outcome measures to future clinical biomarkers.
abstract: Some patients with chronic inflammatory demyelinating polyradiculoneuropathy who respond to initial intravenous immunoglobulin require repeated courses over prolonged periods of time; however, evidence to guide dosage and interval of intravenous immunoglobulin during maintenance therapy is limited. Optimizing treatment requires assessment of underlying disease activity and clinical outcome. Electrophysiological measures of demyelination, and clinical measures using handgrip strength and walking velocity promise to be particularly informative. Major advances in resolution and image processing have expanded clinical applications for ultrasound to include the study of peripheral nerves. Ultrasonography shows promise in diagnosing chronic inflammatory demyelinating polyradiculoneuropathy and distinguishing it from other conditions, providing first ever insight into gross pathology of peripheral nerves. Ultrasonography may also have a role in monitoring disease activity and treatment response.
authors.affiliation: University of Toronto, Toronto General Hospital/UHN, Toronto, ON, Canada.
authors.forename: Hans D
authors.initials: HD
authors.lastname: Katzberg
authors.affiliation: Weill Cornell Medical College, NY, USA.
authors.forename: Norman
authors.initials: N
authors.lastname: Latov
authors.affiliation: Wake Forest University School of Medicine, Winston-Salem, NC, USA.
authors.forename: Francis O
authors.initials: FO
authors.lastname: Walker
mesh_terms: D015415:Biomarkers; D003937:Diagnosis, Differential; D018737:Hand Strength; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D060046:Maintenance Chemotherapy / Q000379:methods*; D017063:Outcome Assessment, Health Care; D020277:Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D011446:Prospective Studies; D014463:Ultrasonography; D000072797:Walking Speed
chemical_list: D015415:Biomarkers; D016756:Immunoglobulins, Intravenous
keywords: chronic inflammatory demyelinating polyradiculoneuropathy; electrophysiology; gait analysis; high-resolution ultrasound