Timing and Course of Clinical Response to Intravenous Immunoglobulin in Chronic Inflammatory Demyelinating Polyradiculoneuropathy
| Autor: | Latov, N, Deng, C, Dalakas, Mc, Bril, V, Donofrio, P, Hanna, K, Hartung, Hp, Hughes, Ra, Merkies, Is, van Doorn, Pa, Ice, Sg, Apostolski, S, Banach, M, Barroso, F, Bartosik Psujek, H, Basta, I, Bednarik, J, Belniak, E, Benedetti, L, Buchman, A, Caress, J, Chapman, K, Chyrchel, U, del Carro, U, Drory, V, Dubrovsky, A, Ehler, E, Fryze, W, Fulgenzi, E, Gibson, G, Gonzalez Cornejo, S, Gonzalez Jaime, Jd, Grandis, Marina, Haas, J, Kaminski, M, Marchesoni, C, Munch, C, Narciso, E, Nations, S, Nogues, M, Patwa, H, Pavlovic, S, Pizzorno, M, Reisin, R, Romero Vargas, S, Ruiz Sandoval, Jl, Ruiz Sandoval, Md, Schenone, Angelo, Selmaj, K, Stelmasiak, Z, Szczudlik, A, Thomas, Fp, Tsao, B, Trivedi, J, Uncini, A, Villa, A, Vohanka, S, Wolfe, G, Zapletalova, O. |
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| Přispěvatelé: | Klinische Neurowetenschappen, RS: MHeNs School for Mental Health and Neuroscience, Neurology |
| Jazyk: | angličtina |
| Rok vydání: | 2010 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors CONTROLLED TRIAL POLYNEUROPATHY Neural Conduction Action Potentials Placebo Loading dose Drug Administration Schedule law.invention Grip strength Disability Evaluation Arts and Humanities (miscellaneous) Maintenance therapy Randomized controlled trial Double-Blind Method law Internal medicine medicine Humans Immunologic Factors Muscle Strength Aged Aged 80 and over Cross-Over Studies Hand Strength Maintenance dose business.industry Immunoglobulins Intravenous Middle Aged Crossover study Clinical trial Treatment Outcome Polyradiculoneuropathy Chronic Inflammatory Demyelinating Physical therapy Female Neurology (clinical) business |
| Zdroj: | Archives of Neurology, 67(7), 802-807. AMA Archives of Neurology, 67(7), 802-807. American Medical Association |
| ISSN: | 0003-9942 |
| DOI: | 10.1001/archneurol.2010.105 |
| Popis: | Objective To investigate the timing, course, and clinical characteristics of the response to intravenous immunoglobulin in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Design Data were extracted from the ICE trial, a randomized, double-blind, placebo-controlled trial of immune globulin intravenous, 10% caprylate/chromatography purified (IGIV-C). Setting Multiple international centers. Participants One hundred seventeen individuals with CIDP. Intervention Treatment with IGIV-C (Gamunex, n = 59) or placebo (n = 58), with IGIV-C administered as a 2-g/kg loading dose followed by a 1-g/kg maintenance dose every 3 weeks, for up to 24 weeks. Main Outcome Measures The primary efficacy parameter was an improvement of 1 or more points in adjusted Inflammatory Neuropathy Cause and Treatment (INCAT) disability score. Participants treated with IGIV-C were divided into subgroups based on meeting responder vs nonresponder definitions and by time to first improvement. Results Among 30 responders to IGIV-C, 14 (47%) patients had improved adjusted INCAT scores by week 3, and 16 (53%) patients improved at week 6 after a second infusion. Participants who improved by week 3 were more severely disabled at baseline than those who improved at 6 weeks. In patients who improved, the number of individuals reaching maximal improvement continued to increase during maintenance therapy for up to 24 weeks. For patients with first improvement by week 3, the change in dominant-hand grip strength over time tended to parallel the INCAT score. In patients with first improvement by week 6, however, the improvement in dominant-hand grip strength preceded initial improvement in INCAT score. Conclusions Data suggest that treatment with 2 courses of IGIV-C administered 3 weeks apart may be required for initial improvement, and continued maintenance therapy may be necessary to achieve a maximal therapeutic response. Trial Registration clinicaltrials.gov Identifier:NCT00220740 |
| Databáze: | OpenAIRE |
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