Corticosteroids in chronic inflammatory demyelinating polyneuropathy

A retrospective, multicentre study, comparing efficacy and safety of daily prednisolone, pulsed dexamethasone, and pulsed intravenous methylprednisolone

G. G.A. van Lieverloo, S. Peric, P. E. Doneddu, F. Gallia, A. Nikolic, L. Wieske, C. Verhamme, I. N. van Schaik, E. Nobile-Orazio, I. Basta, F. Eftimov

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Chronic inflammatory demyelinating polyneuropathy (CIDP) can be treated with corticosteroids or intravenous immunoglobulins. Various corticosteroid regimens are currently used in CIDP, but it is unknown whether they are equally efficacious. In this retrospective study, we compared efficacy and safety of three corticosteroid regimens in CIDP patients. Methods: We included treatment naïve patients that fulfilled the EFNS/PNS criteria for CIDP. Patients were treated with corticosteroids according to the local protocol of three CIDP expertise centres. Corticosteroid regimens consisted of daily oral prednisolone, pulsed oral dexamethasone, or pulsed intravenous methylprednisolone. Outcomes were number of responders to treatment, remission rate of treatment responders, overall probability of 5-year remission, and the occurrence of adverse events. Results: A total of 125 patients were included. Sixty-seven (54%) patients received daily prednisone or prednisolone, 37 (30%) pulsed dexamethasone, and 21 (17%) pulsed intravenous methylprednisolone. Overall, 60% (95% CI 51–69%) responded to corticosteroids, with no significant difference between the three treatment regimens (p = 0.56). From the 75 responders, 61% (95% CI 50–73%) remained in remission, during a median follow-up of 55 months (range 1–197 months). The probability of responders reaching 5-year remission was 55% (95% Cl 44–70%), with no difference between the three groups. Adverse events leading to a change in treatment occurred in ten patients (8%). Two patients had a serious adverse event. Conclusion: Corticosteroids lead to improvement in 60% of patients and to remission in 61% of treatment responders. There were no differences between treatment modalities in terms of efficacy and safety.

Original languageEnglish
Pages (from-to)2052-2059
Number of pages8
JournalJournal of Neurology
Volume265
Issue number9
DOIs
Publication statusPublished - Sep 1 2018

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Chronic Inflammatory Demyelinating Polyradiculoneuropathy
Methylprednisolone
Prednisolone
Dexamethasone
Multicenter Studies
Adrenal Cortex Hormones
Retrospective Studies
Safety
Therapeutics
Intravenous Immunoglobulins
Prednisone

Keywords

  • (Cortico)steroids
  • CIDP
  • Immunosuppressive treatment
  • Peripheral nerve disorder

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Corticosteroids in chronic inflammatory demyelinating polyneuropathy : A retrospective, multicentre study, comparing efficacy and safety of daily prednisolone, pulsed dexamethasone, and pulsed intravenous methylprednisolone. / van Lieverloo, G. G.A.; Peric, S.; Doneddu, P. E.; Gallia, F.; Nikolic, A.; Wieske, L.; Verhamme, C.; van Schaik, I. N.; Nobile-Orazio, E.; Basta, I.; Eftimov, F.

In: Journal of Neurology, Vol. 265, No. 9, 01.09.2018, p. 2052-2059.

Research output: Contribution to journalArticle

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abstract = "Background: Chronic inflammatory demyelinating polyneuropathy (CIDP) can be treated with corticosteroids or intravenous immunoglobulins. Various corticosteroid regimens are currently used in CIDP, but it is unknown whether they are equally efficacious. In this retrospective study, we compared efficacy and safety of three corticosteroid regimens in CIDP patients. Methods: We included treatment na{\"i}ve patients that fulfilled the EFNS/PNS criteria for CIDP. Patients were treated with corticosteroids according to the local protocol of three CIDP expertise centres. Corticosteroid regimens consisted of daily oral prednisolone, pulsed oral dexamethasone, or pulsed intravenous methylprednisolone. Outcomes were number of responders to treatment, remission rate of treatment responders, overall probability of 5-year remission, and the occurrence of adverse events. Results: A total of 125 patients were included. Sixty-seven (54{\%}) patients received daily prednisone or prednisolone, 37 (30{\%}) pulsed dexamethasone, and 21 (17{\%}) pulsed intravenous methylprednisolone. Overall, 60{\%} (95{\%} CI 51–69{\%}) responded to corticosteroids, with no significant difference between the three treatment regimens (p = 0.56). From the 75 responders, 61{\%} (95{\%} CI 50–73{\%}) remained in remission, during a median follow-up of 55 months (range 1–197 months). The probability of responders reaching 5-year remission was 55{\%} (95{\%} Cl 44–70{\%}), with no difference between the three groups. Adverse events leading to a change in treatment occurred in ten patients (8{\%}). Two patients had a serious adverse event. Conclusion: Corticosteroids lead to improvement in 60{\%} of patients and to remission in 61{\%} of treatment responders. There were no differences between treatment modalities in terms of efficacy and safety.",
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T2 - A retrospective, multicentre study, comparing efficacy and safety of daily prednisolone, pulsed dexamethasone, and pulsed intravenous methylprednisolone

AU - van Lieverloo, G. G.A.

AU - Peric, S.

AU - Doneddu, P. E.

AU - Gallia, F.

AU - Nikolic, A.

AU - Wieske, L.

AU - Verhamme, C.

AU - van Schaik, I. N.

AU - Nobile-Orazio, E.

AU - Basta, I.

AU - Eftimov, F.

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AB - Background: Chronic inflammatory demyelinating polyneuropathy (CIDP) can be treated with corticosteroids or intravenous immunoglobulins. Various corticosteroid regimens are currently used in CIDP, but it is unknown whether they are equally efficacious. In this retrospective study, we compared efficacy and safety of three corticosteroid regimens in CIDP patients. Methods: We included treatment naïve patients that fulfilled the EFNS/PNS criteria for CIDP. Patients were treated with corticosteroids according to the local protocol of three CIDP expertise centres. Corticosteroid regimens consisted of daily oral prednisolone, pulsed oral dexamethasone, or pulsed intravenous methylprednisolone. Outcomes were number of responders to treatment, remission rate of treatment responders, overall probability of 5-year remission, and the occurrence of adverse events. Results: A total of 125 patients were included. Sixty-seven (54%) patients received daily prednisone or prednisolone, 37 (30%) pulsed dexamethasone, and 21 (17%) pulsed intravenous methylprednisolone. Overall, 60% (95% CI 51–69%) responded to corticosteroids, with no significant difference between the three treatment regimens (p = 0.56). From the 75 responders, 61% (95% CI 50–73%) remained in remission, during a median follow-up of 55 months (range 1–197 months). The probability of responders reaching 5-year remission was 55% (95% Cl 44–70%), with no difference between the three groups. Adverse events leading to a change in treatment occurred in ten patients (8%). Two patients had a serious adverse event. Conclusion: Corticosteroids lead to improvement in 60% of patients and to remission in 61% of treatment responders. There were no differences between treatment modalities in terms of efficacy and safety.

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