Home monitoring of maintenance intravenous immunoglobulin therapy in patients with chronic inflammatory neuropathy

To evaluate the utility of different outcome measures to monitor dose adjustment of intravenous immunoglobulin (IVIg) therapy in patients with chronic inflammatory neuropathy (CIN). We assessed the adjustment of IVIg maintenance therapy in 20 patients (10 CIDP and 10 MMN) by regularly monitoring gri...

Full description

Saved in:
Bibliographic Details
Published in:Journal of the peripheral nervous system 2020-09, Vol.25 (3), p.238-246
Main Authors: Doneddu, Pietro Emiliano, Mandia, Daniele, Gentile, Francesco, Gallia, Francesca, Liberatore, Giuseppe, Terenghi, Fabrizia, Ruiz, Marta, Nobile‐Orazio, Eduardo
Format: Article
Language:English
Subjects:
CIDP
grip strength
Immunoglobulins
Inflammation
Intravenous administration
intravenous immunoglobulin
multifocal motor neuropathy
Neuropathy
outcome measures
Patients
Quality of life
Rods
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:To evaluate the utility of different outcome measures to monitor dose adjustment of intravenous immunoglobulin (IVIg) therapy in patients with chronic inflammatory neuropathy (CIN). We assessed the adjustment of IVIg maintenance therapy in 20 patients (10 CIDP and 10 MMN) by regularly monitoring grip strength (GS) using a Martin Vigorimeter, RODS, and quality of life using the SF‐36 questionnaire. These measures were regularly performed by the patient at home. We also assessed the extended MRC sumscore (eMRC sumscore) at each outpatient visit for IVIg infusion. We also enrolled 30 healthy controls to measure any possible training effect of GS with time and to analyze random fluctuation of GS. Clinically relevant change was detected by eMRC sumscore in 14 (93%) patients, by RODS in 11 (73%) patients, and by GS in 8 (53%) patients. Early sensitivity was greatest for RODS (73%), followed by GS (53%), and eMRC sumscore (27%). This differed from CIDP, with an early change in RODS in 100% of patients, and MMN with an early change in GS in 75%. None of the outcome measures alone was sufficient to detect clinically significant changes in all patients. Home monitoring of outcome measures objectively assisted clinical decision during individualization of IVIg treatment. We recommend a multimodal approach using different outcome measures to monitor the individual patient with CIN.
ISSN:1085-9489
1529-8027
DOI:10.1111/jns.12396