Subcutaneous immunoglobulin preserves muscle strength in chronic inflammatory demyelinating polyneuropathy

Markvardsen, Lars Kjøbsted; Harbo, Thomas; Sindrup, Søren Hein; Christiansen, I; Andersen, Henning; Jakobsen, Janus Christian

doi:10.1111/ene.12513

Cited by 66 publications

(64 citation statements)

References 21 publications

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“…[13][14][15] One recent study investigated MUNIX as an indicator of secondary axonal loss in CIDP. [19][20][21][22] However, little is known about the electrophysiological changes and their relation to clinical improvement during treatment of CIDP. 17,18 Although not as well established as IVIG, subcutaneous immunoglobulins (SCIG) have shown an effect in CIDP.…”

Section: Introductionmentioning

confidence: 99%

The electrophysiological response to immunoglobulin therapy in chronic inflammatory demyelinating polyneuropathy

et al. 2016

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Section: Introductionmentioning

confidence: 99%

The electrophysiological response to immunoglobulin therapy in chronic inflammatory demyelinating polyneuropathy

et al. 2016

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“…Isokinetic testing protocols, described by Harbo et al 39 have been used as an outcome measure in studies exploring the safety and efficacy of subcutaneous administration of immumoglobulins in CIDP. [40][41][42] Cost and space constraints limit the utility of isokinetic dynamometry in the routine clinical care setting. The assessment also can be timely to perform and requires expertise on the part of the evaluator to become familiar with the testing protocols.…”

Section: Manual Muscle Strength Testing and Isokinetic Strength Testingmentioning

confidence: 99%

Optimizing the Use of Outcome Measures in Chronic Inflammatory Demyelinating Polyneuropathy

Allen¹,

Gelinas

Lewis

et al. 2017

US Neurology

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The challenges encountered during the assessment of patients with chronic inflammatory demyelinating polyneuropathy (CIDP) are many. Ideally, CIDP outcome measures capture impairments in disability, strength, and sensory dysfunction, and quality of life (QoL). A number of outcome measures have been validated for this purpose. Disability outcomes include the adjusted inflammatory neuropathy cause and treatment (INCAT) disability score, INCAT overall disability sum score (ODSS), and overall neuropathy limitations scale (ONLS). A more sensitive disability score, the inflammatory Rasch-built overall disability scale (I-RODS), has also been validated for use in clinical trials and may better capture clinically meaningful changes in those with CIDP. Strength and sensory impairment can be assessed in a number of ways, including the INCAT sensory subscore (ISS), Medical Research Council sum score, and Martin vigorimeter or Jamar dynamometer grip strength. However, the feasibility of applying and interpreting these measures during routine daily practice has been questioned. Furthermore, these outcome measures may not reflect other factors that can impair QoL in those affected by CIDP, such as pain and fatigue. A valid, reliable, and responsive composite measure that addresses all aspects of impairment faced by patients with CIDP remains an unmet need in clinical practice.

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“…In a small CIDP trial, 30 patients were randomized to SCIG or placebo at home. After 12 weeks, the SCIG group had a statistically improved strength and stability of electrophysiology compared with placebo [93]. Large-scale controlled studies are ongoing, examining the safety, formula of transitioning from IVIG to SCIG, and efficacy and patients' preference.…”

Section: The Emerging Role Of Subcutaneous Iggmentioning

confidence: 99%

Efficacy of Intravenous Immunoglobulin in Neurological Diseases

2016

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Owing to its anti-inflammatory efficacy in various autoimmune disease conditions, intravenous immunoglobulin (IVIG)-pooled IgG obtained from the plasma of several thousands individuals-has been used for nearly three decades and is proving to be efficient in a growing number of neurological diseases. IVIG therapy has been firmly established for the treatment of Guillain-Barré syndrome, chronic inflammatory demyelinating polyneuropathy, and multifocal motor neuropathy, either as first-line therapy or adjunctive treatment. IVIG is also recommended as rescue therapy in patients with worsening myasthenia gravis and is beneficial as a second-line therapy for dermatomyositis and stiff-person syndrome. Subcutaneous rather than intravenous administration of IgG is gaining momentum because of its effectiveness in patients with primary immunodeficiency and the ease with which it can be administered independently from hospital-based infusions. The demand for IVIG therapy is growing, resulting in rising costs and supply shortages. Strategies to replace IVIG with recombinant products have been developed based on proposed mechanisms that confer the anti-inflammatory activity of IVIG, but their efficacy has not been tested in clinical trials. This review covers new developments in the immunobiology and clinical applications of IVIG in neurological diseases.

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Subcutaneous immunoglobulin preserves muscle strength in chronic inflammatory demyelinating polyneuropathy

Abstract: SCIG preserves muscle strength and functional ability in patients with CIDP who previously responded to IVIG. SCIG should be considered as an alternative in long-term treatment of CIDP patients.

Cited by 66 publications

References 21 publications

The electrophysiological response to immunoglobulin therapy in chronic inflammatory demyelinating polyneuropathy

The electrophysiological response to immunoglobulin therapy in chronic inflammatory demyelinating polyneuropathy

Optimizing the Use of Outcome Measures in Chronic Inflammatory Demyelinating Polyneuropathy

Efficacy of Intravenous Immunoglobulin in Neurological Diseases

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