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Abstract Details

Efficacy and Safety of Subcutaneous Immunoglobulin in Patients with Chronic Inflammatory Demyelinating Polyneuropathy: A Systematic Review of RCTs
Neuromuscular and Clinical Neurophysiology (EMG)
P10 - Poster Session 10 (5:00 PM-6:00 PM)
11-022
This systematic review explored the efficacy and safety of subcutaneous Immunoglobulin (SCIG) in patients with Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP).
Recently SCIG has received Attention in providing clinical improvement in patients with CIDP. Compared to intravenous immunoglobulin, subcutaneous administration has better patient compliance and fewer systemic side effects.

 A systematic search of PubMed and Clinicialtrials.gov was conducted using pre-specified keywords following the PRISMA guidelines. RCTs studying the Inflammatory Neuropathy Cause And Treatment (INCAT) disability score, Inflammatory Rasch-built Overall Disability Scale (I-RODS), Medical Research Council (MRC) Sum score, Grip strength scores and relapse rates as primary outcomes were selected.


Five RCTs filled the necessary criteria and were included in the systematic review [n=284, male= 178(62.7%)]. A 0.2g/kg weekly dosing showed higher relapse rates (33-50%), and mild to no significant improvement in the post-treatment INCAT, I-RODS, Grip strength, and MRC SUM scores. A 0.4g/kg weekly SCIG showed significant clinical improvement and lesser relapses in patients (10-19%). Monthly maintenance therapy with hyaluronidase facilitated SCIG 10% also reduced the relapse rates by 9.7% [95% CI 4.5%, 19.6%]. Adverse events included local skin reactions (22% to 38.7%), infections (10% to 24.4%), headaches (7% to 35%), fatigue (12% to 35%), gastrointestinal issues such as nausea and diarrhoea (12% to 19.4%), CIDP worsening (18%), and hypertension (6.4%).


A weekly subcutaneous immunoglobulin at a dose of 0.4g/kg significantly reduces the clinical deterioration and the risk of relapse in patients with CIDP with a well-tolerable safety profile. Further research with a diverse and larger population is necessary to confirm these findings.
Authors/Disclosures
Advait Teli, MBBS
PRESENTER
Dr. Teli has nothing to disclose.
Ananya Talukdar Ms. Talukdar has nothing to disclose.
Siddhartha Kakani Mr. Kakani has nothing to disclose.
Trisha Shivashankar Trisha Shivashankar has nothing to disclose.