Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands.
Department of Neurology, St Elisabeth Hospital, Willemstad, Curaçao.
J Peripher Nerv Syst. 2019 Mar;24(1):48-55. doi: 10.1111/jns.12302. Epub 2019 Feb 15.
Intravenous immunoglobulin (IVIG) is a potential therapy for chronic inflammatory demyelinating polyneuropathy (CIDP). To investigate the efficacy and safety of the IVIG IgPro10 (Privigen) for treatment of CIDP, results from Privigen Impact on Mobility and Autonomy (PRIMA), a prospective, open-label, single-arm study of IVIG in immunoglobulin (Ig)-naïve or IVIG pre-treated subjects (NCT01184846, n = 28) and Polyneuropathy And Treatment with Hizentra (PATH), a double-blind, randomized study including an open-label, single-arm IVIG phase in IVIG pre-treated subjects (NCT01545076, IVIG restabilization phase n = 207) were analyzed separately and together (n = 235). Efficacy assessments included change in adjusted inflammatory neuropathy cause and treatment (INCAT) score, grip strength and Medical Research Council (MRC) sum score. Adverse drug reactions (ADRs) and ADRs/infusion were recorded. Adjusted INCAT response rate was 60.7% in all PRIMA subjects at Week 25 (76.9% in IVIG pre-treated subjects) and 72.9% in PATH. In the pooled cohort (n = 235), INCAT response rate was 71.5%; median time to INCAT improvement was 4.3 weeks. No clear demographic differences were noticed between early (responding before Week 7, n = 148) and late responders (n = 21). In the pooled cohort, median change from baseline to last observation was -1.0 (interquartile range -2.0; 0.0) point for INCAT score; +8.0 (0.0; 20.0) kPa for maximum grip strength; +3.0 (1.0; 7.0) points for MRC sum score. In the pooled cohort, 271 ADRs were reported in 105 subjects (44.7%), a rate of 0.144 ADRs per infusion. This analysis confirms the efficacy and safety of IgPro10, a recently FDA-approved IVIG for CIDP, in a population of mainly pre-treated subjects with CIDP [Correction added on 14 March 2019 after first online publication: the INCAT response rate has been corrected.].
静脉注射免疫球蛋白(IVIG)是治疗慢性炎症性脱髓鞘性多发性神经病(CIDP)的一种潜在疗法。为了研究 IVIG IgPro10(Privigen)治疗 CIDP 的疗效和安全性,对 Privigen Impact on Mobility and Autonomy(PRIMA)[NCT01184846,n=28,为免疫球蛋白(Ig)初治或 IVIG 预处理受试者的前瞻性、开放标签、单臂 IVIG 研究]和 Polyneuropathy And Treatment with Hizentra(PATH)[NCT01545076,IVIG 再稳定阶段 n=207,包括 IVIG 预处理受试者的双盲、随机研究和开放标签、单臂 IVIG 阶段]的结果进行了分别和联合分析(n=235)。疗效评估包括调整后的炎症性神经病病因和治疗(INCAT)评分、握力和医学研究委员会(MRC)总评分的变化。记录药物不良反应(ADR)和 ADR/输注。在所有 PRIMA 受试者中,调整后的 INCAT 应答率在第 25 周为 60.7%(IVIG 预处理受试者中为 76.9%),在 PATH 中为 72.9%。在合并队列(n=235)中,INCAT 应答率为 71.5%;INCAT 改善的中位时间为 4.3 周。在早期(应答时间<7 周,n=148)和晚期(n=21)应答者之间,未观察到明显的人口统计学差异。在合并队列中,从基线到最后观察的中位数变化为 INCAT 评分-1.0(四分位距-2.0;0.0)点;最大握力+8.0(0.0;20.0)kPa;MRC 总分+3.0(1.0;7.0)点。在合并队列中,105 名受试者(44.7%)报告了 271 例药物不良反应(ADR),每输注 0.144 例 ADR。这项分析证实了 IgPro10 的疗效和安全性,IgPro10 是最近获得 FDA 批准的 CIDP 用 IVIG,在主要为 CIDP 预处理的受试者人群中使用[更正:在首次在线出版后于 2019 年 3 月 14 日添加更正:INCAT 应答率已更正。]。