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

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

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Pages (from-to)729-734
Number of pages6
JournalJournal of Neurology, Neurosurgery and Psychiatry
Volume86
Issue number7
DOIs
Publication statusPublished - Jul 1 2015

ASJC Scopus subject areas

  • Clinical Neurology
  • Psychiatry and Mental health
  • Surgery
  • Arts and Humanities (miscellaneous)
  • Medicine(all)

Fingerprint Dive into the research topics of 'Frequency and time to relapse after discontinuing 6-month therapy with IVIg or pulsed methylprednisolone in CIDP'. Together they form a unique fingerprint.

Cite this