Electrophysiological testing in chronic inflammatory demyelinating polyneuropathy patients treated with subcutaneous immunoglobulin: The Polyneuropathy And Treatment with Hizentra (PATH) study.

Autor: Bril V; Ellen and Martin Prosserman Centre for Neuromuscular Diseases, Division of Neurology, Department of Medicine, University Health Network, University of Toronto, Toronto, Canada; Institute for Research and Medical Consultations, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia. Electronic address: vera.bril@utoronto.ca., Hartung HP; Department of Neurology, UKD and Center for Neurology and Neuropsychiatry, LVR Klinikum, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany., Lawo JP; CSL Behring, Marburg, Germany., Durn BL; CSL Behring, King of Prussia, PA, USA., Mielke O; CSL Behring, Marburg, Germany.
Jazyk: angličtina
Zdroj: Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology [Clin Neurophysiol] 2021 Jan; Vol. 132 (1), pp. 226-231. Date of Electronic Publication: 2020 Sep 14.
DOI: 10.1016/j.clinph.2020.09.001
Abstrakt: Objective: To assess electrophysiology parameters that can reflect patients' clinical status and show changes in nerve function with treatment, in a study of subcutaneous immunoglobulin in chronic inflammatory demyelinating polyneuropathy.
Methods: Nerve conduction studies (latency, conduction velocity, conduction block and compound muscle action potential [CMAP] on upper limb median, ulnar, and lower limb peroneal motor nerves) were conducted in the placebo-controlled PATH (Polyneuropathy And Treatment with Hizentra) study of two doses of maintenance subcutaneous immunoglobulin (SCIG) IgPro20 in CIDP.
Results: Averaged proximal latency substantially increased with placebo (+1.1 ms) indicating electrophysiologic deterioration but remained stable with IgPro20 (0.2 g/kg bodyweight [bw]: +0.1 ms; 0.4 g/kg bw: -0.1 ms). Distal latencies were also more prolonged with placebo versus IgPro20. Averaged motor nerve conduction velocity substantially decreased with placebo (-1.6 m/s) versus increasing in both IgPro20 groups (+0.2 m/s and +1.0 m/s, respectively). Conduction block and CMAP amplitudes did not change substantially.
Conclusion: These findings support the effectiveness of maintenance IgPro20, as nerve function changed in the direction of increasing nerve dysfunction with placebo but remained stable with ongoing IgPro20 therapy.
Significance: Electrophysiology testing can support assessment of clinical status in CIDP to determine treatment efficacy.
Competing Interests: Declaration of Competing Interest VB is a consultant to CSL Behring, Grifols, Union Chimique Belge, Takeda, Alylam, Alexion and ArgenX. She serves on international scientific advisory boards for the Myasthenia Gravis Foundation of America and Guillain-Barré Syndrome/Chronic Inflammatory Demyelinating Polyneuropathy (CIDP/GBS) Foundation International, and has received research support from CSL Behring, Grifols, Union Chimique Belge, and ArgenX. H-PH received fees for consulting or serving on steering committees or advertisement boards from Baxter, Bayer Healthcare, Biogen, CSL Behring, Geneuro, Kedrion, Laboratoire francais du Fractionnement et des Biotechnologies, MedImmune, Merck, Novartis, Octapharma, Receptos Celgene, Roche, Sanofi Genzyme, and Teva, with approval by the Rector of Heinrich-Heine-University Düsseldorf. J-PL is a CSL employee and biostatistician for this study. BLD was a CSL Behring employee during this study.
(Copyright © 2020 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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