Institut de Recerca Biomèdica Sant Pau, Barcelona, Spain.
Huron Consulting Group, London, UK.
J Neurol. 2021 Oct;268(10):3706-3716. doi: 10.1007/s00415-020-09998-8. Epub 2020 Jun 24.
Chronic inflammatory demyelinating polyneuropathy (CIDP) is a rare neurological disorder characterised by muscle weakness and impaired sensory function. The present study provides a comprehensive literature review of the burden of illness of CIDP.
Systematic literature search of PubMed, Embase, and key conferences in May 2019. Search terms identified studies on the epidemiology, humanistic burden, current treatment, and economic burden of CIDP published since 2009 in English.
Forty-five full texts and nineteen conference proceedings were identified on the epidemiology (n = 9), humanistic burden (n = 7), current treatment (n = 40), and economic burden (n = 8) of CIDP. Epidemiological studies showed incidence and prevalence of 0.2-1.6 and 0.8-8.9 per 100,000, respectively, depending on geography and diagnostic criteria. Humanistic burden studies revealed that patients experienced physical and psychosocial burden, including impaired physical function, pain and depression. Publications on current treatments reported on six main types of therapy: intravenous immunoglobulins, subcutaneous immunoglobulins, corticosteroids, plasma exchange, immunosuppressants, and immunomodulators. Treatments may be burdensome, due to adverse events and reduced independence caused by treatment administration setting. In Germany, UK, France, and the US, CIDP economic burden was driven by direct costs of treatment and hospitalisation. CIDP was associated with indirect costs driven by impaired productivity.
This first systematic review of CIDP burden of illness demonstrates the high physical and psychosocial burden of this rare disease. Future research is required to fully characterise the burden of CIDP, and to understand how appropriate treatment can mitigate burden for patients and healthcare systems.
慢性炎症性脱髓鞘性多发性神经病(CIDP)是一种罕见的神经系统疾病,其特征为肌肉无力和感觉功能受损。本研究对 CIDP 的疾病负担进行了全面的文献综述。
2019 年 5 月,对 PubMed、Embase 和主要会议进行了系统性文献检索。检索词确定了自 2009 年以来以英文发表的关于 CIDP 的流行病学、人文负担、当前治疗和经济负担的研究。
确定了 45 篇全文和 19 篇会议论文,涉及 CIDP 的流行病学(n=9)、人文负担(n=7)、当前治疗(n=40)和经济负担(n=8)。流行病学研究表明,发病率和患病率分别为每 10 万人 0.2-1.6 和 0.8-8.9,具体取决于地理位置和诊断标准。人文负担研究表明,患者存在身体和心理社会负担,包括身体功能受损、疼痛和抑郁。关于当前治疗的出版物报告了六种主要的治疗类型:静脉注射免疫球蛋白、皮下免疫球蛋白、皮质类固醇、血浆置换、免疫抑制剂和免疫调节剂。由于治疗管理环境导致的不良反应和独立性降低,治疗可能会带来负担。在德国、英国、法国和美国,CIDP 的经济负担由治疗和住院的直接费用驱动。CIDP 与生产力受损导致的间接成本有关。
这是对 CIDP 疾病负担的首次系统综述,表明这种罕见疾病存在较高的身体和心理社会负担。需要进一步研究以充分描述 CIDP 的负担,并了解适当的治疗如何减轻患者和医疗保健系统的负担。