Abstract Details

Title All-cause Mortality in Patient with Chronic Inflammatory Demyelinating Polyneuropathy after Immunomodulatory Therapy versus No Treatment

Topic Autoimmune Neurology

Presentation(s) Autoimmune Neurology Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 061

Objective

To compare all-cause mortality rate in patients with chronic inflammatory demyelinating polyneuropathy (CIDP) who received immunomodulatory therapy versus no treatment.

Background CIDP is a progressive disease with high risk of relapse, however, the advent of immunomodulatory therapies has improved the disease course and outcomes. The effect of immunomodulatory therapy on all-cause mortality in patients with CIDP is unknown.

Design/Methods We designed a retrospective study using the Statewide Planning and Research Cooperative System (SPARCS) database to identify patients with CIDP. Data were pooled on demographics, comorbidities, treatment status, and all-cause mortality. Statistical analyses were performed using univariate and multivariate regression models.

Results We identified 4790 patients with CIDP between 1998-2014. Of which, 1266 patients received immunomodulatory therapy (steroid (11%), plasmapheresis (8%), IVIG (75%), and combination therapy (6%)) and 3524 had no treatment. There was no significant difference in average age between the two groups (61.9 ± 16.2 vs 62.6 ± 16.3; p=0.2), however, in treatment group the proportion of male patients were higher (63% vs 58%; p=0.005). All-cause mortality rates in immunomodulatory therapy group and no treatment group were 4% and 7%, respectively. After adjusting for baseline characteristics and comorbidities, all-cause mortality was significantly higher in no treatment group compared to immunomodulatory therapy group (OR: 1.94, 95% CI: 1.27-2.98; p=0.002). In subgroup analysis, no significant differences were found among different immunomodulatory therapies (IVIG, reference; steroid OR 2.2, (95% CI: 0.74-6.24); plasmapheresis OR 1.25 (95%CI: 0.42-3.72)).

Conclusions

Patients with CIDP who received immunomodulatory therapy have significantly lower rate of all-cause mortality. Further studies are required to elucidate the prolonged effect of immunomodulation on CIDP and related medical conditions.

Authors/Disclosures
Keyvan Heshmati, MD PRESENTER	Dr. Heshmati has nothing to disclose.
Abu Nasar	No disclosure on file
Gabriel R. Arismendi, MD (Rutgers New Jersey Medical School)	Dr. Arismendi has nothing to disclose.
Claire Ruane	Ms. Ruane has nothing to disclose.
Parisorn Thepmankorn (Rutgers New Jersey Medical School)	Ms. Thepmankorn has received personal compensation for serving as an employee of Johnson and Johnson.
Nizar Souayah, MD, FAAN (NJMS)	Dr. Souayah has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Takeda. Dr. Souayah has received publishing royalties from a publication relating to health care.

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