Layton JB, Anderson-Smits C, Ritchey ME, Chavan S, Souayah N. Treatment patterns of US patients with chronic inflammatory demyelinating polyradiculoneuropathy. Poster presented at the 2020 Virtual American Association of Neuromuscular and Electrodiagnostic Medicine Annual Meeting; October 2020. [abstract] Muscle Nerve. 2020 Oct; p.126.

INTRODUCTION: Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a rare, immune-mediated neuropathy, and IVIg is a first-line therapy option.

OBJECTIVE: To examine real-world practices with IVIg, including ramp-up, dosing patterns, switching, discontinuation, and add-on therapy. We describe treatment patterns among CIDP patients initiating IVIg treatment.

METHODS: Adults with CIDP without prior immunoglobulin treatment were identified in the MarketScan® insurance database between 2008-2018. Patients subsequently initiating IVIg were identified. Timing and frequency of dosing, switching to other immunoglobulin treatments, discontinuation of the index IVIg, and initiation of other CIDP treatments were described.

RESULTS: Of 32,090 Ig-naïve patients with CIDP identified, 3975 initiated IVIg. Few patients had previous non-Ig CIDP therapy, except for high-dose corticosteroids (34%). Median number of doses during 14-day ramp-up was 1 (interquartile range [IQR] 1-3). After ramp-up, the median interim between doses was 21 days (IQR 7-28) and median treatment duration was 129 days (IQR 85-271). At year 1 of followup, a higher proportion (27%) of patients discontinued the index IVIg compared with those who switched Ig treatment (6%). Most patients who discontinued did so by the fourth treatment month; 45% of patients initiated another non-Ig CIDP treatment after IVIg initiation.

SUMMARY/CONCLUSION: Most patients who initiated IVIg treatment did not have prior CIDP treatment. IVIg is typically administered every 1-4 weeks. Many patients discontinued treatment by the eighth month; after which less discontinuation happens, which is consistent with rates in the literature.

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