WED 223 Predicting disease activity in inflammatory neuropathies

Abstract

BackgroundThere is currently no accurate way to determine who will need long-term immunoglobulin (IVIg) treatment in chronic inflammatory demyelinating polyneuropathy (CIDP) and multifocal motor neuropathy (MMN).AimsRetrospectively compare clinical, investigational and treatment factors in patients who have successfully ceased IVIg with patients who have active disease.Methods15 patients who have successfully suspended IVIg infusions were compared with 15 in whom decreasing the IVIg dose was unsuccessful.Results30 patients (12 with CIDP and 3 with MMN in both groups) were diagnosed 39.5 months from onset of symptoms in the successful group vs 40.7 months in the unsuccessful group (p=0.953). There was a significant difference in the summed upper limb sensory amplitudes on electrophysiology prior to starting IVIg between the patients with CIDP (17.4 mV vs 9.8 mV p=0.007). There was no difference between the average doses between the groups. A successful cessation trial was attempted at a mean of 60.5 months post starting treatment, compared with 60 months in the unsuccessful patients.ConclusionOther than the differences in initial upper limb amplitudes, other factors did not help predict a successful cessation trial of IVIg. This reinforces the need for an objective biomarker to measure disease activity.