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Preventing long-term disability in CIDP: the role of timely diagnosis and treatment monitoring in a multicenter CIDP cohort.
Quint, Paula; Schroeter, Christina B; Kohle, Felix; Öztürk, Menekse; Meisel, Andreas; Tamburrino, Giuliano; Mausberg, Anne K; Szepanowski, Fabian; Afzali, Ali Maisam; Fischer, Katinka; Nelke, Christopher; Räuber, Saskia; Voth, Jan; Masanneck, Lars; Willison, Alice; Vogelsang, Anna; Hemmer, Bernhard; Berthele, Achim; Schroeter, Michael; Hartung, Hans-Peter; Pawlitzki, Marc; Schreiber, Stefanie; Stettner, Mark; Maus, Uwe; Meuth, Sven G; Stascheit, Frauke; Ruck, Tobias.
Afiliación
  • Quint P; Department of Neurology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.
  • Schroeter CB; Department of Neurology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.
  • Kohle F; Department of Neurology, Faculty of Medicine, University of Cologne and University Hospital of Cologne, Cologne, Germany.
  • Öztürk M; Department of Neurology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.
  • Meisel A; Department of Neurology and Experimental Neurology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany.
  • Tamburrino G; Neuroscience Clinical Research Center, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany.
  • Mausberg AK; Department of Neurology, Faculty of Medicine, University of Cologne and University Hospital of Cologne, Cologne, Germany.
  • Szepanowski F; Department of Neurology, Essen University Hospital, University Duisburg-Essen, Essen, Germany.
  • Afzali AM; Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany.
  • Fischer K; Department of Neurology, Essen University Hospital, University Duisburg-Essen, Essen, Germany.
  • Nelke C; Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany.
  • Räuber S; Department of Neurology, Klinikum Rechts der Isar, Technical University Munich School of Medicine and Health, Ismaninger Str. 22, 81675, Munich, Germany.
  • Voth J; Institute for Experimental Neuroimmunology, Technical University of Munich School of Medicine and Health, Munich, Germany.
  • Masanneck L; Department of Neurology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.
  • Willison A; Department of Neurology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.
  • Vogelsang A; Department of Neurology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.
  • Hemmer B; Department of Neurology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.
  • Berthele A; Department of Neurology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.
  • Schroeter M; Department of Neurology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.
  • Hartung HP; Department of Neurology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.
  • Pawlitzki M; Department of Neurology, Klinikum Rechts der Isar, Technical University Munich School of Medicine and Health, Ismaninger Str. 22, 81675, Munich, Germany.
  • Schreiber S; Munich Cluster for Systems Neurology (SyNergy), 81377, Munich, Germany.
  • Stettner M; Department of Neurology, Klinikum Rechts der Isar, Technical University Munich School of Medicine and Health, Ismaninger Str. 22, 81675, Munich, Germany.
  • Maus U; Department of Neurology, Faculty of Medicine, University of Cologne and University Hospital of Cologne, Cologne, Germany.
  • Meuth SG; Department of Neurology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.
  • Stascheit F; Brain and Mind Center, University of Sydney, 94 Mallett St, Sydney, Australia.
  • Ruck T; Department of Neurology, Palacky University Olomouc, Nová Ulice, 779 00, Olomouc, Czech Republic.
J Neurol ; 271(9): 5930-5943, 2024 Sep.
Article en En | MEDLINE | ID: mdl-38990346
ABSTRACT

BACKGROUND:

Chronic inflammatory demyelinating polyneuropathy (CIDP) is an inflammatory disease affecting the peripheral nerves and the most frequent autoimmune polyneuropathy. Given the lack of established biomarkers or risk factors for the development of CIDP and patients' treatment response, this research effort seeks to identify potential clinical factors that may influence disease progression and overall treatment efficacy.

METHODS:

In this multicenter, retrospective analysis, we have screened 197 CIDP patients who presented to the University Hospitals in Düsseldorf, Berlin, Cologne, Essen, Magdeburg and Munich between 2018 and 2022. We utilized the respective hospital information system and examined baseline data with clinical examination, medical letters, laboratory results, antibody status, nerve conduction studies, imaging and biopsy findings. Aside from clinical baseline data, we analyzed treatment outcomes using the Standard of Care (SOC) definition, as well as a comparison of an early (within the first 12 months after manifestation) versus late (more than 12 months after manifestation) onset of therapy.

RESULTS:

In terms of treatment, most patients received intravenous immunoglobulin (56%) or prednisolone (39%) as their first therapy. Patients who started their initial treatment later experienced a worsening disease course, as reflected by a significant deterioration in their Inflammatory Neuropathy Cause and Treatment (INCAT) leg disability score. SOC-refractory patients had worse clinical outcomes than SOC-responders. Associated factors for SOC-refractory status included the presence of fatigue as a symptom and alcohol dependence.

CONCLUSION:

Timely diagnosis, prompt initiation of treatment and careful monitoring of treatment response are essential for the prevention of long-term disability in CIDP and suggest a "hit hard and early" treatment paradigm.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Polirradiculoneuropatía Crónica Inflamatoria Desmielinizante Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Neurol Año: 2024 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Alemania
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Polirradiculoneuropatía Crónica Inflamatoria Desmielinizante Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Neurol Año: 2024 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Alemania