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Subcutaneous immunoglobulin in CIDP and MMN: a short-term nationwide study |
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| Authors: | Dario Cocito Aristide Merola Erdita Peci Anna Mazzeo Raffaella Fazio Ada Francia Paola Valentino Rocco Liguori Massimiliano Filosto Gabriele Siciliano Angelo Maurizio Clerici Stefania Lelli Girolama Alessandra Marfia Giovanni Antonini Ilaria Cecconi Eduardo Nobile-Orazio Leonardo Lopiano SCIg and Chronic Dysimmune Neuropathies Italian Network |
| Institution: | 1. Department of Neuroscience, University of Turin, Via Cherasco 15, 10126, Turin, Italy 2. Department of Neuroscience, Psychiatry and Anesthesiology, A.O.U. Policlinico “G. Martino”, Messina, Italy 3. Department of Neurology, IRCCS San Raffaele Milano, Milano, Italy 4. III Neurological Clinic, Policlinico Umberto I, Roma, Italy 5. Department of Medical and Surgical Sciences, Neurological Clinic, University Magna Grecia of Catanzaro, Catanzaro, Italy 6. Neurological Clinic IRCCS, Institute of Neurological Sciences of Bologna, Bologna, Italy 7. Neuromuscular Diseases and Neuropathies Section, Neurological Clinic, University and A.O “Spedali Civili” of Brescia, Brescia, Italy 8. Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy 9. Neurology and Stroke Unit, A.O. Hospital Varese, Circolo and Fondazione Macchi, University of Insubria, Varese, Italy 10. Unit of Neurology, Hospital San Giacomo Apostolo, Castelfranco Veneto, Italy 11. Department of Neuroscience, Policlinico tor Vergata, Rome, Italy 12. Neurological Sciences, University “La Sapienza” of Rome, Rome, Italy 13. Child Neuropsychiatry Unit, Hospital Sant’Orsola Malpighi Bologna, Bologna, Italy 14. Neurology 2, Department of Translational Medicine, IRCCS Istituto Clinico Humanitas, University of Milano, Rozzano, Italy |
| Abstract: | This multi-center Italian prospective observational study reports the 4 months follow-up data of 87 patients affected by chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and multifocal motor neuropathy (MMN) shifted from intravenous to subcutaneous immunoglobulin treatment. A therapeutic shift from intravenous to subcutaneous immunoglobulin was performed in 87 patients (66 CIDP; 21 MMN) affected by immune-mediated peripheral neuropathies with evidence of a sustained clinical response to intravenous immunoglobulin. Patients were evaluated by means of the Overall Neuropathy Limitation Scale, Medical Research Council Scale and Life Quality Index questionnaire, both at the time of therapeutic shift and after 4 months of subcutaneous immunoglobulin treatment. A sustained clinical efficacy was observed after the switch to subcutaneous immunoglobulin: the Overall Neuropathy Limitation Scale score improved in the group of 66 CIDP patients (P = 0.018), with only one subject reporting a worsening of 1 point, and remained stable in the group of 21 MMN patients (P = 0.841), with one subject reporting a worsening of two points. An improvement in the patient’s perception of therapeutic setting was reported in both groups. This large multi-center study confirms the short-term clinical equivalence of subcutaneous versus intravenous immunoglobulin and a possible improvement in the patient’s perception of therapeutic setting with the subcutaneous administration. However, further studies are required to extend the results to a longer observational period. |
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