Dipartimento di Neuroscienze, AOU San Giovanni Battista, Torino, Italy.
Eur J Neurol. 2010 Feb;17(2):289-94. doi: 10.1111/j.1468-1331.2009.02802.x. Epub 2009 Oct 23.
The guidelines for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) therapy suggest to use immunoglobulins (IVIg) and steroid as first-line therapies. Patients who do not respond to one of the two drugs should be switched to the other drug. We collected therapeutic outcome data in patients followed at 11 centres in order to document the clinical practice in Italy.
Clinical and electrophysiological data of patients with CIDP were entered into a central database. The clinical outcome (Rankin Scale) and drug side effects (SE) for first- and second-line therapies were recorded.
A total of 267 patients were included. The percentage of responders (R) to first-line therapy [steroid or IVIg or plasma exchange (PE)] was 69%; this number increased to 81% when patients who switched to different therapies were included. Overall, the percentage of R to IVIg was similar to R to steroids (P = 0.07) and higher than R to PE (P < 0.001). Of the main therapies, PE frequently caused SE (19%), followed by steroids (12.5%) and IVIg (4%).
Switching between traditional therapies increases the number of responder patients. IVIg was confirmed to be a therapy with low SE.
慢性炎症性脱髓鞘性多发性神经根神经病（CIDP）的治疗指南建议使用免疫球蛋白（IVIg）和类固醇作为一线治疗。对这两种药物之一无反应的患者应改用另一种药物。我们在 11 个中心收集了患者的治疗结果数据，以便记录意大利的临床实践。
将 CIDP 患者的临床和电生理数据输入中央数据库。记录一线治疗（类固醇或 IVIg 或血浆置换（PE））的临床结局（Rankin 量表）和药物副作用（SE）。
共纳入 267 例患者。一线治疗[类固醇或 IVIg 或血浆置换（PE）]的应答者（R）比例为 69%；当包括改用不同疗法的患者时，这一比例增加到 81%。总体而言，IVIg 的 R 比例与类固醇相似（P = 0.07），高于 PE（P < 0.001）。在主要治疗中，PE 常引起 SE（19%），其次是类固醇（12.5%）和 IVIg（4%）。
在传统疗法之间转换可增加应答者患者的数量。IVIg 被证实是一种 SE 较低的治疗方法。
