Clinical and Neurophysiological Follow-Up of Chronic Inflammatory Demyelinating Polyneuropathy Patients Treated with Subcutaneous Immunoglobulins: A Real-Life Single Center Study.

CIDP INCAT ISS MRC SCIg SNAP cMAP subcutaneous immunoglobulin

Journal

Brain sciences
ISSN: 2076-3425
Titre abrégé: Brain Sci
Pays: Switzerland
ID NLM: 101598646

Informations de publication

Date de publication:
21 Dec 2022
Historique:
received: 25 11 2022
revised: 17 12 2022
accepted: 18 12 2022
entrez: 21 1 2023
pubmed: 22 1 2023
medline: 22 1 2023
Statut: epublish

Résumé

chronic idiopathic demyelinating polyneuropathy (CIDP) is an acquired, immune-mediated neuropathy characterized by weakness, sensory symptoms and significant reduction or loss of deep tendon reflexes evolving over 2 months at least, associated with electrophysiological evidence of peripheral nerve demyelination. Recently, subcutaneous immunoglobulins (SCIg) have been introduced in clinical practice as a maintenance therapy for CIDP; nevertheless, electrophysiological and efficacy data are limited. to evaluate SCIg treatment efficacy, we retrospectively reviewed data from 15 CIDP patients referring to our clinic, receiving SCIg treatment and who performed electrophysiological studies (NCS) and clinical scores (MRC sumscore, INCAT disability score and ISS) before starting the treatment and at least one year after. NCS showed no significant changes before and during treatment for all the nerves explored. Clinical scores did not significantly change between evaluations. Correlation analysis evidenced a positive correlation of cMAPs distal amplitude with MRC sumscore and a trend of negative correlation with the INCAT disability score. SCIg maintenance therapy preserves nerve function in CIDP with a good efficacy and safety. Treatment effectiveness can be assessed with ENG, which represents a useful instrument in the follow-up and prognostic assessment of CIDP.

Sections du résumé

BACKGROUND BACKGROUND
chronic idiopathic demyelinating polyneuropathy (CIDP) is an acquired, immune-mediated neuropathy characterized by weakness, sensory symptoms and significant reduction or loss of deep tendon reflexes evolving over 2 months at least, associated with electrophysiological evidence of peripheral nerve demyelination. Recently, subcutaneous immunoglobulins (SCIg) have been introduced in clinical practice as a maintenance therapy for CIDP; nevertheless, electrophysiological and efficacy data are limited.
METHODS METHODS
to evaluate SCIg treatment efficacy, we retrospectively reviewed data from 15 CIDP patients referring to our clinic, receiving SCIg treatment and who performed electrophysiological studies (NCS) and clinical scores (MRC sumscore, INCAT disability score and ISS) before starting the treatment and at least one year after.
RESULTS RESULTS
NCS showed no significant changes before and during treatment for all the nerves explored. Clinical scores did not significantly change between evaluations. Correlation analysis evidenced a positive correlation of cMAPs distal amplitude with MRC sumscore and a trend of negative correlation with the INCAT disability score.
CONCLUSIONS CONCLUSIONS
SCIg maintenance therapy preserves nerve function in CIDP with a good efficacy and safety. Treatment effectiveness can be assessed with ENG, which represents a useful instrument in the follow-up and prognostic assessment of CIDP.

Identifiants

pubmed: 36671992
pii: brainsci13010010
doi: 10.3390/brainsci13010010
pmc: PMC9856456
pii:
doi:

Types de publication

Journal Article

Langues

eng

Références

Muscle Nerve. 1991 Nov;14(11):1103-9
pubmed: 1745285
Clin Neurophysiol. 2021 Sep;132(9):2184-2190
pubmed: 34293528
Muscle Nerve. 2019 Dec;60(6):662-667
pubmed: 31415091
Eur J Neurol. 2021 Nov;28(11):3556-3583
pubmed: 34327760
Muscle Nerve. 2015 Mar;51(3):315-26
pubmed: 25418426
Lancet Neurol. 2019 Aug;18(8):784-794
pubmed: 31076244
Arch Neurol. 2010 Sep;67(9):1082-8
pubmed: 20837852
J Peripher Nerv Syst. 2014 Mar;19(1):2-13
pubmed: 24612201
Sci Rep. 2020 May 13;10(1):7910
pubmed: 32404895
Muscle Nerve. 2002 Mar;25(3):370-7
pubmed: 11870713
Ann Neurol. 2001 Aug;50(2):195-201
pubmed: 11506402
Curr Opin Neurol. 2018 Oct;31(5):511-516
pubmed: 30045075
Adv Exp Med Biol. 2019;1190:333-343
pubmed: 31760654
CNS Drugs. 2019 Aug;33(8):831-838
pubmed: 31347096
Clin Neurophysiol. 2018 May;129(5):967-973
pubmed: 29554579
Int J Mol Sci. 2021 Dec 24;23(1):
pubmed: 35008604

Auteurs

Paolo Alonge (P)

Neurology Unit, Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo, 90129 Palermo, Italy.

Vincenzo Di Stefano (V)

Neurology Unit, Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo, 90129 Palermo, Italy.

Antonino Lupica (A)

Neurology Unit, Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo, 90129 Palermo, Italy.

Massimo Gangitano (M)

Neurology Unit, Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo, 90129 Palermo, Italy.

Angelo Torrente (A)

Neurology Unit, Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo, 90129 Palermo, Italy.

Antonia Pignolo (A)

Neurology Unit, Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo, 90129 Palermo, Italy.

Bruna Maggio (B)

Neurology Unit, Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo, 90129 Palermo, Italy.

Salvatore Iacono (S)

Neurology Unit, Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo, 90129 Palermo, Italy.

Francesca Gentile (F)

Neurology Unit, Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo, 90129 Palermo, Italy.

Filippo Brighina (F)

Neurology Unit, Department of Biomedicine, Neuroscience, and Advanced Diagnostics (BiND), University of Palermo, 90129 Palermo, Italy.

Classifications MeSH