Real-World Study Highlights Reduced Disability Progression of CIDP With Immunoglobulin Therapy

Rajiv Mallick, PhD

(Credit: LinkedIn)

A newly presented real-world study reported that patients with chronic inflammatory demyelinating polyneuropathy (CIDP) treated with immunoglobulin (Ig) therapy had less deterioration in assistive device use than those not treated with Ig therapy, suggesting that those in the treated population experienced a reduction in disability progression.¹

Researchers used US claims and electronic medical records between January 2015 and November 2021 to identify adults diagnosed with CIDP and confirmed by nerve conduction studies. In the study, Ig-treated patients were matched via propensity scores to untreated patients. Over 6-month baseline and follow-up periods, deterioration was assessed using claims for assistive devices, with at least 1 or 2 levels of change indicating worsening disability. Compared with nonIg-treated patients, fewer Ig-treated patients showed at least 1 level (3.3% vs. 5.4%; P = .104) and at least 2 levels (3.1% vs. 5.1%; P = .0079) of deterioration.

Overall, the final matched cohort included 1302 pairs of Ig-treated and nonIg-treated patients, with a mean age of 61 years and approximately 60% men. Disability progression was measured using changes in claims for assistive devices, such as transitioning from a walker to a wheelchair. Led by Rajiv Mallick, PhD, director of global health economics and reimbursement strategy at CSL Behring, the data revealed that the Ig-treated group experienced significantly less progression in both at least 1 and 2 levels of assistive device use.

Investigators also examined opioid use as a secondary outcome in this study. Among Ig-treated patients, opioid use declined from baseline to follow-up (39.2% to 37.3%; P <.0001), whereas opioid use remained stable in the nonIg-treated group. In patients with baseline opioid use, researchers reported a lower proportion of Ig-treated individuals had follow-up opioid claims (58.5% vs. 67.9%; P = .0021). Presented at the 2025 Peripheral Nerve Society (PNS) Annual Meeting, held May 17-20, in Edinburgh, Scotland, the study authors noted the findings suggest that Ig therapy may be associated with reduced disability progression and lower opioid use in patients with CIDP, which is consistent with benefits of Ig therapy observed in previous clinical trials.²

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Real-world data from a previously published study in Neurology and Therapy provided further insight into treatment patterns and outcomes associated with intravenous immunoglobulin (IVIg) use in patients with CIDP, where findings showed frequent early discontinuation of therapy and reductions in impaired functional status over time.³ Using data from the Merative MarketScan Research Databases between 2008 and 2018, researchers identified 3975 adults with CIDP who initiated IVIG without prior immunoglobulin exposure.

After the initial loading dose, patients received IVIg at a median interval of 21 days and continued treatment for a median of 129 days. In 2 years, 55% of patients had discontinued all IVIg, with over half of those stopping treatment in 4 months. Diagnoses of impaired functional status, present in over 30% of patients at baseline, were observed at lower rates during follow-up. Researchers reported that new-onset safety outcomes after IVIg initiation were infrequent.

Patients in the cohort, which had a median age of 58 years, received IVIg following a variable schedule with a dosing interval ranging from 7 to 28 days (interquartile range), and most treatments lasting under a year. Researchers recorded impaired functional status at baseline in more than 30% of patients and observed that it declined over time. The study also reported low rates of new safety issues associated with IVIG, which were identified through diagnosis codes.

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REFERENCES
1. Mallick R, Divino V, Coyle K, et al. Real-World Effectiveness of Immunoglobulin Therapy in Chronic Inflammatory Demyelinating Polyneuropathy (CIDP). Presented at: 2025 Peripheral Nerve Society (PNS) Annual Meeting; May 17-20; Edinburgh, Scotland. P327.
2. Terhoeven P, Seybold J, Utz KS, Nickel FT, Lee DH, Linker RA. Longer-term effects of intravenous immunoglobulin treatment in chronic inflammatory demyelinating polyneuropathy: Who benefits?. J Neurol Sci. 2020;419:117169. doi:10.1016/j.jns.2020.117169
3. Anderson-Smits C, Ritchey ME, Huang Z, et al. Intravenous Immunoglobulin Treatment Patterns and Outcomes in Patients with Chronic Inflammatory Demyelinating Polyradiculoneuropathy: A US Claims Database Analysis. Neurol Ther. 2023;12(4):1119-1132. doi:10.1007/s40120-023-00478-5