Outcome in chronic inflammatory demyelinating polyneuropathy: A systematic review and meta-analysis

Area of Science:

• Neurology
• Immunology
• Clinical Epidemiology

Background:

• Chronic inflammatory demyelinating polyneuropathy (CIDP) outcomes vary significantly across studies.
• Uncertainty in long-term disease prognosis necessitates a comprehensive analysis.

Approach:

• A systematic review and meta-analysis was performed following PRISMA guidelines.
• Searched PubMed and EMBASE for studies with ≥2 years follow-up, published by May 2022.
• Analyzed data from 21 studies including 1199 patients, assessing case fatality, ambulation, physical function, and remission rates.

Key Points:

• Pooled case fatality rate for CIDP was 3.3% (95% CI, 1.9%–5.7%).
• 8.2% of CIDP patients were nonambulatory (95% CI, 5.7%–11.6%).
• 47.1% of patients experienced a good outcome without disability (95% CI, 39.5%–54.9%).
• The pooled remission rate was 40.8% (95% CI, 30.6%–51.8%).

Conclusions:

• CIDP has a significant impact on patient mobility and long-term function.
• While many patients achieve remission, strategies to prevent long-term impairment are needed.
• Clinical strategies should consider avoiding immunomodulating therapy in patients with established remission.