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.

Home monitoring of maintenance intravenous immunoglobulin therapy in patients with chronic inflammatory neuropathy / P.E. Doneddu, D. Mandia, F. Gentile, F. Gallia, G. Liberatore, F. Terenghi, M. Ruiz, E. Nobile-Orazio. - In: JOURNAL OF THE PERIPHERAL NERVOUS SYSTEM. - ISSN 1085-9489. - 25:3(2020 Sep 01), pp. 238-246. [10.1111/jns.12396]

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

F. Gentile;F. Gallia;F. Terenghi;E. Nobile-Orazio
Ultimo
Writing – Review & Editing
2020

Abstract

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.
CIDP; grip strength; intravenous immunoglobulin; multifocal motor neuropathy; outcome measures
Settore MED/26 - Neurologia
1-set-2020
Article (author)
File in questo prodotto:
File Dimensione Formato  
jns.12396.pdf

accesso riservato

Tipologia: Publisher's version/PDF
Dimensione 1.22 MB
Formato Adobe PDF
1.22 MB Adobe PDF   Visualizza/Apri   Richiedi una copia
Vigorimetro Manuscript edo.pdf

accesso aperto

Tipologia: Pre-print (manoscritto inviato all'editore)
Dimensione 154 kB
Formato Adobe PDF
154 kB Adobe PDF Visualizza/Apri
Vigorimetro Table 1. Pazienti baseline.pdf

accesso aperto

Tipologia: Pre-print (manoscritto inviato all'editore)
Dimensione 68.58 kB
Formato Adobe PDF
68.58 kB Adobe PDF Visualizza/Apri
Vigorimetro Table 2. Controlli.pdf

accesso aperto

Tipologia: Pre-print (manoscritto inviato all'editore)
Dimensione 56.3 kB
Formato Adobe PDF
56.3 kB Adobe PDF Visualizza/Apri
Vigorimetro Table 3. Pazienti terapia.pdf

accesso aperto

Tipologia: Pre-print (manoscritto inviato all'editore)
Dimensione 61.74 kB
Formato Adobe PDF
61.74 kB Adobe PDF Visualizza/Apri
Pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/779311
Citazioni
  • ???jsp.display-item.citation.pmc??? 4
  • Scopus 14
  • ???jsp.display-item.citation.isi??? 13
social impact