Effect of Treatments on All-Cause of Mortality in Chronic Inflammatory Demyelinating Polyneuropathy (S19.008)

Abstract

<h3>Objective:</h3> To investigate the effect on mortality of different treatments of chronic inflammatory demyelinating polyneuropathy (CIDP). <h3>Background:</h3> Treatment options, which include plasmapheresis, IVIg, steroids, immunosuppressants, or a combination of these and their effectiveness in reducing overall mortality remain a question of high interest in studying the outcomes of CIDP. <h3>Design/Methods:</h3> We used the New York State Planning and Research Cooperation (SPARCS) database to retrospectively collect all patients with CIDP from 1998–2018. ICD 9 and 10 codes were used to identify comorbidities. Mortality data was collected using discharge status as either expired or sent to hospice. Multivariate analysis with binary logistic regression adjusted for comorbidities, gender, and age. Comorbidities included type 2 diabetes, hypertension, heart failure, COPD, Parkinson’s disease, multiple sclerosis, autoimmune hypothyroidism, pneumonia, and a multitude of cardiovascular diseases were assessed from the date of diagnosis. Pearson Chi Squared test was used to test for significance. <h3>Results:</h3> 8,096 patients with CIDP were identified from 1998–2018.169 patients were treated with only plasmapheresis (2.0%), 602 patients were treated with only steroids (7.4%), 27 were treated with only immunosuppressants (0.3%), 1,802 were treated with only IVIg (22.2%), and 538 were treated with a combination therapy (6.6%). There was no significant difference in gender (p=0.119) or age (p=0.585) between those who were treated and those who were not treated. Multivariable binary logistic regression there was no significant difference in the likelihood of death whether a patient was ever treated or not treated (OR: 1.011; 95% CL: 0830–1.232; p=0.912). <h3>Conclusions:</h3> CIDP patients with a history of treatment with plasmapheresis, steroids, immunosuppressants, IVIg or a combination at any time, when confounding for all comorbid conditions, gender and age did not significantly affect mortality when compared to patients who did not. Work is in progress for subgroup analysis and identifying other risk factors for mortality including hospital admission and socioeconomic status. <b>Disclosure:</b> Miss Shaikh has nothing to disclose. Mr. Choudhry has nothing to disclose. Mr. Choudhry has nothing to disclose. Mr. Jaffry has nothing to disclose. Mr. Trivedi has nothing to disclose. Mr. Mandava has nothing to disclose. Mr. Jaffry has nothing to disclose. Mr. Ors has nothing to disclose. Ms. Faiz has nothing to disclose. Dr. Souayah has received publishing royalties from a publication relating to health care.