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Predicting response to treatment in chronic inflammatory demyelinating polyradiculoneuropathy
Y-C Chan1, D C Allen, D Fialho
1Department of Clinical Neuroscience, Guy's Campus, King's College, London SE1 1UL, UK. yeecheun@yahoo.com.sg
Journal of Neurology, Neurosurgery, and Psychiatry
|December 20, 2005
Summary
The Inflammatory Neuropathy Cause and Treatment Group (INCAT) criteria do not predict immunotherapy response in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Patients with probable CIDP should still trial immunotherapy.
Area of Science:
- Neurology
- Clinical Electrophysiology
Background:
- Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a rare autoimmune disorder affecting peripheral nerves.
- Accurate electrophysiological classification is crucial for guiding treatment decisions in CIDP.
Purpose of the Study:
- To evaluate if the Inflammatory Neuropathy Cause and Treatment Group (INCAT) electrophysiological criteria predict treatment response in CIDP patients.
- To determine if neurophysiologically definite CIDP predicts a better response to immunotherapy compared to probable CIDP.
Main Methods:
- Retrospective case note study of 50 CIDP patients treated between 2001 and 2004.
- Nerve conduction studies (NCS) were reviewed against modified INCAT criteria to classify patients as definite or probable CIDP.
- Treatment response to corticosteroids, IVIg, or plasma exchange was compared between the two groups.
Main Results:
- Of 50 patients, 27 (54%) were definite CIDP and 23 (46%) were probable CIDP.
- Treatment response rates were similar: 74% for definite CIDP and 73.9% for probable CIDP.
- No significant difference in immunotherapy response was observed based on INCAT electrophysiological criteria.
Conclusions:
- The INCAT electrophysiological criteria do not reliably predict immunotherapy response in CIDP.
- Patients classified as neurophysiologically probable CIDP should be considered for a trial of immunotherapy.
- Further research may explore other biomarkers for predicting treatment response in CIDP.
