Electrophysiological testing in chronic inflammatory demyelinating polyneuropathy patients treated with subcutaneous immunoglobulin: The Polyneuropathy And Treatment with Hizentra (PATH) study. Issue 1 (January 2021)

• Record Type: Journal Article
• Authors: Bril, Vera; Hartung, Hans-Peter; Lawo, John-Philip; Durn, Billie L.; Mielke, Orell
• Is Part Of: Clinical neurophysiology. Volume 132:Issue 1(2021)
• Page Start: 226
• Page End: 231
• Publication Date: 2021-01
• Subjects: Chronic inflammatory demyelinating polyneuropathy -- Subcutaneous immunoglobulin -- IgPro20 -- Electrophysiology -- Nerve conduction studies; Neurophysiology -- Periodicals; Electroencephalography -- Periodicals; Electromyography -- Periodicals; Neurology -- Periodicals; 612.8
• DOI: 10.1016/j.clinph.2020.09.001
• Languages: English
• ISSNs: 1388-2457

Abstract

Highlights: NCSs were conducted in the PATH study of maintenance SCIG (IgPro20) in CIDP. Conduction velocity decreased with placebo but increased with SCIG. Nerves showed increasing dysfunction with placebo but remained stable with IgPro20. Abstract: 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.