This report examined data from a multicentre, randomised, double-blind, placebo controlled, parallel-group study in patients with CIDP: 45 patients, 24 intravenous immunoglobulin (IVIg), 21 intravenous methylprednisolone (IMP) completed the study. The study is registered under the EUDRACT number 2005-001136-76 and was approved by the ethics committees of all the participating centres. At present, few data are available on correlations between changes in nerve motor and sensory conduction study and clinical outcomes; particularly, can electrophysiology predict treatment response? Before enrollment and six months after, the nerve-conduction measurement on a minimum of eight motor and six sensory nerves were performed. The analysis of the variations in the two most relevant motor nerves for the diagnosis of CIDP showed a marginal non-significant improvement in both groups in distal and proximal amplitude of compound muscle action potentials, in motor conduction velocities, but not in the number of nerves with conduction block. The only significant difference was in the reduction in the distal latency in the IVIg group. The analysis of the per-protocol population showed a significant improvement in motor nerve conduction velocity and reduction in distal latency in the IVIg group but also an increase in the number of nerves with conduction block; there was no significant difference compared with the IMP group. In addition, the analysis of our data documented that: 1) there is no difference in the clinical response to IMP in patients with a pattern of focal demyelination, and 2) the amplitude or conduction velocity of the most affected motor nerves and the other electrophysiological parameters evaluated before therapy were not predictive of responder status. These findings are partially in accordance with those made by Bril et al. (2010) and recommend to treat with IVIg or IMP also the patients presenting serious electrophysiological alterations before therapy. S24
CAN ELECTROPHYSIOLOGY PREDICT CLINICAL OUTCOMES IN CIDP? / Cocito, D; Paolasso, I; Liotta, G; Peci, E; Jann, S; Uncini, A; Beghi, E; Antonini, Giovanni; Fazio, R; Schenone, A.. - In: JOURNAL OF THE PERIPHERAL NERVOUS SYSTEM. - ISSN 1085-9489. - STAMPA. - 18:(2013), pp. 24-24.
CAN ELECTROPHYSIOLOGY PREDICT CLINICAL OUTCOMES IN CIDP?
ANTONINI, Giovanni;
2013
Abstract
This report examined data from a multicentre, randomised, double-blind, placebo controlled, parallel-group study in patients with CIDP: 45 patients, 24 intravenous immunoglobulin (IVIg), 21 intravenous methylprednisolone (IMP) completed the study. The study is registered under the EUDRACT number 2005-001136-76 and was approved by the ethics committees of all the participating centres. At present, few data are available on correlations between changes in nerve motor and sensory conduction study and clinical outcomes; particularly, can electrophysiology predict treatment response? Before enrollment and six months after, the nerve-conduction measurement on a minimum of eight motor and six sensory nerves were performed. The analysis of the variations in the two most relevant motor nerves for the diagnosis of CIDP showed a marginal non-significant improvement in both groups in distal and proximal amplitude of compound muscle action potentials, in motor conduction velocities, but not in the number of nerves with conduction block. The only significant difference was in the reduction in the distal latency in the IVIg group. The analysis of the per-protocol population showed a significant improvement in motor nerve conduction velocity and reduction in distal latency in the IVIg group but also an increase in the number of nerves with conduction block; there was no significant difference compared with the IMP group. In addition, the analysis of our data documented that: 1) there is no difference in the clinical response to IMP in patients with a pattern of focal demyelination, and 2) the amplitude or conduction velocity of the most affected motor nerves and the other electrophysiological parameters evaluated before therapy were not predictive of responder status. These findings are partially in accordance with those made by Bril et al. (2010) and recommend to treat with IVIg or IMP also the patients presenting serious electrophysiological alterations before therapy. S24I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
