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Electrophysiological Testing in Chronic Inflammatory Demyelinating Polyneuropathy Patients Treated With Subcutaneous Immunoglobulin: The Polyneuropathy and Treatment with Hizentra (PATH) Study
Clinical Neurophysiology ( IF 3.7 ) Pub Date : 2021-01-01 , DOI: 10.1016/j.clinph.2020.09.001
Vera Bril 1 , Hans-Peter Hartung 2 , John-Philip Lawo 3 , Billie L Durn 4 , Orell Mielke 3
Affiliation  

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.

中文翻译:

皮下免疫球蛋白治疗慢性炎症性脱髓鞘性多发性神经病患者的电生理检测:多发性神经病和 Hizentra (PATH) 治疗研究

目的在慢性炎性脱髓鞘性多发性神经病皮下免疫球蛋白的研究中,评估可反映患者临床状态并显示治疗后神经功能变化的电生理参数。方法 在安慰剂对照的 PATH(多神经病和 Hizentra 治疗)研究中进行了神经传导研究(潜伏期、传导速度、传导阻滞和上肢正中、尺骨和下肢腓骨运动神经的复合肌肉动作电位 [CMAP])在 CIDP 中使用两剂维持皮下免疫球蛋白 (SCIG) IgPro20。结果 安慰剂的平均近端潜伏期显着增加 (+1.1 ms),表明电生理恶化,但 IgPro20 保持稳定(0.2 g/kg 体重 [bw]:+0.1 ms;0.4 g/kg bw:-0.1 ms)。与 IgPro20 相比,安慰剂组的远端潜伏期也更长。平均运动神经传导速度在安慰剂组中显着降低 (-1.6 m/s),而在两个 IgPro20 组中均增加(分别为 +0.2 m/s 和 +1.0 m/s)。传导阻滞和 CMAP 振幅没有显着变化。结论 这些发现支持维持 IgPro20 的有效性,因为神经功能在安慰剂治疗中朝着增加神经功能障碍的方向改变,但在持续的 IgPro20 治疗中保持稳定。意义 电生理测试可以支持评估 CIDP 的临床状态以确定治疗效果。传导阻滞和 CMAP 振幅没有显着变化。结论 这些发现支持维持 IgPro20 的有效性,因为神经功能在安慰剂治疗中朝着增加神经功能障碍的方向改变,但在持续的 IgPro20 治疗中保持稳定。意义 电生理测试可以支持评估 CIDP 的临床状态以确定治疗效果。传导阻滞和 CMAP 振幅没有显着变化。结论 这些发现支持维持 IgPro20 的有效性,因为神经功能在安慰剂治疗中朝着增加神经功能障碍的方向改变,但在持续的 IgPro20 治疗中保持稳定。意义 电生理测试可以支持评估 CIDP 的临床状态以确定治疗效果。
更新日期:2021-01-01
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