Frequency and time to relapse after discontinuing 6-month therapy with IVIg or pulsed methylprednisolone in CIDP

Mario Sabatelli, Luca Santoro, Ilaria Paolasso, Marco Luigetti, Eduardo Nobile-Orazio, Dario Cocito, Stefano Jann, Antonino Uncini, Paolo Messina, Giovanni Antonini, Raffaella Fazio, Francesca Gallia, Angelo Schenone, Davide Pareyson, Lucio Santoro, Stefano Tamburin, Guido Cavaletti, Fabio Giannini, Ettore Beghi, Francesca NotturnoAlessandro Clemenzi, Francesca Bianchi, Elisabetta Fiorina, Giuseppe Piscosquito, Fiore Manganelli, Maria Luigia Praitano, Marialuisa Piatti, Antonio Torzini, Roberta Macchia

Risultato della ricerca: Contributo in rivistaArticolo in rivista

42 Citazioni (Scopus)

Abstract

Background: We reported that 6-month therapy with intravenous immunoglobulin (IVIg) was more frequently effective or tolerated than intravenous methylprednisolone (IVMP) in patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). We now retrospectively compared the proportion of patients who eventually worsened after discontinuing therapy and the median time to clinical worsening. Methods: By March 2013, data were available from 41 of the 45 patients completing the trial with a median follow-up after therapy discontinuation of 42 months (range 1-60). Three patients withdrew during the original study and one failed to respond to either of the therapies. No patient received a diagnosis alternative to CIDP during the follow-up. Results: Twenty-eight of the 32 patients treated with IVIg (as primary or secondary therapy after failing to respond to IVMP) improved after therapy (87.5%) as compared with 13 of the 24 patients treated with IVMP as primary or secondary therapy (54.2%). After a median follow-up of 42 months (range 1-57), 24 out of 28 patients responsive to IVIg (85.7%) worsened after therapy discontinuation. The same occurred in 10 out of 13 patients (76.9%) responsive to IVMP (p=0.659) after a median follow-up of 43 months (range 7-60). Worsening occurred 1-24 months (median 4.5) after IVIg discontinuation and 1-31 months (median 14) after IVMP discontinuation (p=0.0126). Conclusions: A similarly high proportion of patients treated with IVIg or IVMP eventually relapse after therapy discontinuation but the median time to relapse was significantly longer after IVMP than IVIg. This difference may help to balance the more frequent response to IVIg than to IVMP in patients with CIDP.
Lingua originaleEnglish
pagine (da-a)729-734
Numero di pagine6
RivistaJOURNAL OF NEUROLOGY, NEUROSURGERY AND PSYCHIATRY
Volume86
DOI
Stato di pubblicazionePubblicato - 2015

Keywords

  • Anti-Inflammatory Agents
  • Humans
  • Immunoglobulins, Intravenous
  • Immunologic Factors
  • Methylprednisolone
  • NEUROIMMUNOLOGY
  • NEUROPATHY
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating
  • Recurrence
  • Retrospective Studies
  • STEROIDS
  • Time Factors
  • Treatment Outcome

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