학술논문
Frequency of diabetes and other comorbidities in chronic inflammatory demyelinating polyradiculoneuropathy and their impact on clinical presentation and response to therapy.
Document Type
Academic Journal
Author
Doneddu PE; Neuromuscular and Neuroimmunology Service, Humanitas Clinical and Research Center - IRCCS, Rozzano, Italy.; Cocito D; Divisione di Riabilitazione Neuromotoria, Istituti Clinici Scientifici Maugeri - Presidio Sanitario Major, Torino, Italy.; Manganelli F; Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II of Naples, Naples, Italy.; Fazio R; Department of Neurology, San Raffaele Hospital Institute of Experimental Neurology, Milano, Lombardia, Italy.; Briani C; Department of Neuroscience, University of Padua, Padova, Italy.; Filosto M; Unit of Neurology, ASST 'Spedali Civili', University of Brescia, Brescia, Italy.; Benedetti L; Department of Neurology, IRCCS Ospedale Policlinico San Martino, Genova, Italy.; Bianchi E; Laboratorio di Malattie Neurologiche, IRCCS-Istituto Mario Negri, Milano, Italy.; Jann S; Department of Neuroscience, Niguarda Ca' Granda Hospital, Milano, Italy.; Mazzeo A; Department of Clinical and Experimental Medicine, Unit of Neurology, University of Messina, Messina, Italy.; Antonini G; Department of Neurology Mental Health and Sensory Organs (NESMOS), 'Sapienza' University of Rome, Sant' Andrea Hospital, Roma, Italy.; Cosentino G; Department of Neurology, University of Pavia, IRCCS Mondino Foundation, Pavia, Italy.; Marfia GA; Department of Systems Medicine, Univeristy of Roma Tor Vergata, Rome, Italy.; Cortese A; Department of Neurology, University of Pavia, IRCCS Mondino Foundation, Pavia, Italy.; Clerici AM; Neurology Unit, Circolo & Macchi Foundation Hospital, Insubria University, Varese, Italy.; Carpo M; Department of Neurology, ASST Bergamo Ovest-Ospedale Treviglio, Treviglio, Italy.; Schenone A; Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genoa and IRCCS AOU San Martino-IST, Genoa, Italy.; Siciliano G; Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.; Luigetti M; UOC Neurologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.; Dipartimento di scienze dell'invecchiamento, neurologiche, ortopediche e della testa-collo, Universita Cattolica del Sacro Cuore Sede di Roma, Roma, Italy.; Lauria G; Unit of Neuroalgology, Foundation IRCCS Carlo Besta Neurological Institute, Milano, Italy.; Department of Biomedical and Clinical Sciences 'Luigi Sacco', University of Milan, Milano, Italy.; Rosso T; UOC Neurologia-Castelfranco Veneto, ULSS2 Marca Trevigiana, Treviso, Italy.; Cavaletti G; School of Medicine and Surgery and Experimental Neurology Unit, Universita degli Studi di Milano-Bicocca, Milano, Italy.; Beghi E; Laboratorio di Malattie Neurologiche, IRCCS-Istituto Mario Negri, Milano, Italy.; Liberatore G; Neuromuscular and Neuroimmunology Service, Humanitas Clinical and Research Center - IRCCS, Rozzano, Italy.; Santoro L; Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II of Naples, Naples, Italy.; Spina E; Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II of Naples, Naples, Italy.; Peci E; Department of Neuroscience, University of Turin, Torino, Italy.; Tronci S; Department of Neurology, San Raffaele Hospital Institute of Experimental Neurology, Milano, Lombardia, Italy.; Ruiz M; Department of Neuroscience, University of Padua, Padova, Italy.; Cotti Piccinelli S; Unit of Neurology, ASST 'Spedali Civili', University of Brescia, Brescia, Italy.; Verrengia EP; Department of Neuroscience, Niguarda Ca' Granda Hospital, Milano, Italy.; Gentile L; Department of Clinical and Experimental Medicine, Unit of Neurology, University of Messina, Messina, Italy.; Leonardi L; Department of Neurology Mental Health and Sensory Organs (NESMOS), 'Sapienza' University of Rome, Sant' Andrea Hospital, Roma, Italy.; Mataluni G; Department of Systems Medicine, Univeristy of Roma Tor Vergata, Rome, Italy.; Piccolo L; Department of Neurology, University of Pavia, IRCCS Mondino Foundation, Pavia, Italy.; Nobile-Orazio E; Neuromuscular and Neuroimmunology Service, Humanitas Clinical and Research Center - IRCCS, Rozzano, Italy eduardo.nobile@unimi.it.; Department of Medical Biotechnology and Translational Medicine, University of Milan, Milano, Lombardia, Italy.
Source
Publisher: BMJ Publishing Group Country of Publication: England NLM ID: 2985191R Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1468-330X (Electronic) Linking ISSN: 00223050 NLM ISO Abbreviation: J Neurol Neurosurg Psychiatry Subsets: MEDLINE
Subject
Language
English
Abstract
Objectives: To determine the prevalence of different comorbidities in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), and their impact on outcome, treatment choice and response.
Methods: Using a structured questionnaire, we collected information on comorbidities from 393 patients with CIDP fulfilling the European Federation of Neurological Societies and Peripheral Nerve Society criteria included in the Italian CIDP database.
Results: One or more comorbidities were reported by 294 patients (75%) and potentially influenced treatment choice in 192 (49%) leading to a less frequent use of corticosteroids. Response to treatment did not differ, however, from that in patients without comorbidities. Diabetes (14%), monoclonal gammopathy of undetermined significance (MGUS) (12%) and other immune disorders (16%) were significantly more frequent in patients with CIDP than expected in the general European population. Patients with diabetes had higher disability scores, worse quality of life and a less frequent treatment response compared with patients without diabetes. Patients with IgG-IgA or IgM MGUS had an older age at CIDP onset while patients with other immune disorders had a younger age at onset and were more frequently females. IgM MGUS was more frequent in patients with motor CIDP than in patients with typical CIDP.
Conclusions: Comorbidities are frequent in patients with CIDP and in almost 50% of them have an impact on treatment choice. Diabetes, MGUS and other immune diseases are more frequent in patients with CIDP than in the general population. Only diabetes seems, however, to have an impact on disease severity and treatment response possibly reflecting in some patients a coexisting diabetic neuropathy.
Competing Interests: Competing interests: PED has received travel grants to attend scientific meetings from CSL Behring and Kedrion. DC has received honoraria for lecturing from Shire, CSL Behring and Kedrion and travel grants to attend scientific meeting from Shire, Kedrion, and CSL Behring. FM reports personal fees for scientific events from CSL Behring and has received travel grants to attend scientific meetings from CSL Behring and Kedrion. RF has served on scientific advisory boards for CSL Behring and has received travel grants from Kedrion and CSL Behring to attend scientific meeting. Chiara Briani has served on scientific advisory boards for Pfizer, Alnylam, and Akcea, and has received travel grants from Kedrion and CSL Behring to attend scientific meeting. MF has served on scientific advisory boards for CSL Behring and has received travel grants from Kedrion, Baxter and CSL Behring to attend scientific meeting. SJ has received research grants from Grifols, outside this work, and travel grants from Grifols and Kedrion. Anna Mazzeo has received travel grants from Kedrion and CSL Behring to attend scientific meeting. GC has received travel grants to attend scientific meetings from CSL Behring and Kedrion. AC has received travel grants to attend scientific meetings from Kedrion. MC has received travel grants to attend scientific meetings from Kedrion. ML has received travel grants to attend scientific meetings from Kedrion. GC has received honoraria for lecturing and travel grants to attend scientific meetings from Kedrion. E Beghi reports grants from UCB-Pharma, grants from Shire, grants from EISAI, personal fees from Viropharma, grants from Italian Ministry of Health, grants from Fondazione Borgonovo, grants from Associazione IDIC 15, grants from European Union, outside the submitted work. Giuseppe Liberatore has received travel grants to attend scientific meetings from CSL Behring and Kedrion. Lucio Santoro reports personal fees for scientific events from CSL Behring and has received travel grants to attend scientific meetings from CSL Behring and Kedrion. EP has received travel grants to attend scientific meetings from CSL Behring. Eduardo Nobile Orazio reports personal fees for Advisory or Scientific Board from Kedrion, Italy, Baxter, Italy, Novartis, Switzerland, CSL-Behring, Italy, Astellas, the Netherlands, outside the submitted work and travel grants to attend Scientific Meeting from Baxter, Grifols, Kedrion, and Novartis, Italy. The other authors declare no conflict of interest.
(© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)
Methods: Using a structured questionnaire, we collected information on comorbidities from 393 patients with CIDP fulfilling the European Federation of Neurological Societies and Peripheral Nerve Society criteria included in the Italian CIDP database.
Results: One or more comorbidities were reported by 294 patients (75%) and potentially influenced treatment choice in 192 (49%) leading to a less frequent use of corticosteroids. Response to treatment did not differ, however, from that in patients without comorbidities. Diabetes (14%), monoclonal gammopathy of undetermined significance (MGUS) (12%) and other immune disorders (16%) were significantly more frequent in patients with CIDP than expected in the general European population. Patients with diabetes had higher disability scores, worse quality of life and a less frequent treatment response compared with patients without diabetes. Patients with IgG-IgA or IgM MGUS had an older age at CIDP onset while patients with other immune disorders had a younger age at onset and were more frequently females. IgM MGUS was more frequent in patients with motor CIDP than in patients with typical CIDP.
Conclusions: Comorbidities are frequent in patients with CIDP and in almost 50% of them have an impact on treatment choice. Diabetes, MGUS and other immune diseases are more frequent in patients with CIDP than in the general population. Only diabetes seems, however, to have an impact on disease severity and treatment response possibly reflecting in some patients a coexisting diabetic neuropathy.
Competing Interests: Competing interests: PED has received travel grants to attend scientific meetings from CSL Behring and Kedrion. DC has received honoraria for lecturing from Shire, CSL Behring and Kedrion and travel grants to attend scientific meeting from Shire, Kedrion, and CSL Behring. FM reports personal fees for scientific events from CSL Behring and has received travel grants to attend scientific meetings from CSL Behring and Kedrion. RF has served on scientific advisory boards for CSL Behring and has received travel grants from Kedrion and CSL Behring to attend scientific meeting. Chiara Briani has served on scientific advisory boards for Pfizer, Alnylam, and Akcea, and has received travel grants from Kedrion and CSL Behring to attend scientific meeting. MF has served on scientific advisory boards for CSL Behring and has received travel grants from Kedrion, Baxter and CSL Behring to attend scientific meeting. SJ has received research grants from Grifols, outside this work, and travel grants from Grifols and Kedrion. Anna Mazzeo has received travel grants from Kedrion and CSL Behring to attend scientific meeting. GC has received travel grants to attend scientific meetings from CSL Behring and Kedrion. AC has received travel grants to attend scientific meetings from Kedrion. MC has received travel grants to attend scientific meetings from Kedrion. ML has received travel grants to attend scientific meetings from Kedrion. GC has received honoraria for lecturing and travel grants to attend scientific meetings from Kedrion. E Beghi reports grants from UCB-Pharma, grants from Shire, grants from EISAI, personal fees from Viropharma, grants from Italian Ministry of Health, grants from Fondazione Borgonovo, grants from Associazione IDIC 15, grants from European Union, outside the submitted work. Giuseppe Liberatore has received travel grants to attend scientific meetings from CSL Behring and Kedrion. Lucio Santoro reports personal fees for scientific events from CSL Behring and has received travel grants to attend scientific meetings from CSL Behring and Kedrion. EP has received travel grants to attend scientific meetings from CSL Behring. Eduardo Nobile Orazio reports personal fees for Advisory or Scientific Board from Kedrion, Italy, Baxter, Italy, Novartis, Switzerland, CSL-Behring, Italy, Astellas, the Netherlands, outside the submitted work and travel grants to attend Scientific Meeting from Baxter, Grifols, Kedrion, and Novartis, Italy. The other authors declare no conflict of interest.
(© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)