Cargando…
Single-center experience of induction therapy in non-systemic vasculitic neuropathy
BACKGROUND: No controlled studies for non-systemic vasculitic neuropathy treatment exist (NSVN). We compared the treatment response to induction therapy commonly used in clinical practice in NSVN. METHODS: In this retrospective single-center study, 43 patients with biopsy-proven NSVN were analyzed....
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9377119/ https://www.ncbi.nlm.nih.gov/pubmed/35965348 http://dx.doi.org/10.1186/s42466-022-00198-5 |
_version_ | 1784768275666698240 |
---|---|
author | Schneider, Christian Wassermann, Meike K. Fink, Gereon R. Lehmann, Helmar C. |
author_facet | Schneider, Christian Wassermann, Meike K. Fink, Gereon R. Lehmann, Helmar C. |
author_sort | Schneider, Christian |
collection | PubMed |
description | BACKGROUND: No controlled studies for non-systemic vasculitic neuropathy treatment exist (NSVN). We compared the treatment response to induction therapy commonly used in clinical practice in NSVN. METHODS: In this retrospective single-center study, 43 patients with biopsy-proven NSVN were analyzed. Patients were subdivided into groups depending on their initial treatment. Relapse rates, changes of motor and sensory symptoms, adverse events, predictors of relapses, and second-line treatment were compared. RESULTS: Initial treatment regimens were corticosteroid monotherapy, cyclophosphamide monotherapy, pulsed corticosteroid therapy, and combination therapy. Discontinuation due to adverse events occurred in 6 of 43 patients. Clinical data did not differ between treatment groups. Within 12 months, 24.3% of patients relapsed. The median time to relapse was 4 (1.5, 6) months. No relapse occurred in the combination therapy group. However, there was no statistically significant difference in relapse-free survival between treatment groups (p = 0.58). Neither clinical data nor biopsy analysis predicted relapses sufficiently. As a second-line treatment, cyclophosphamide as mono- or combination therapy was used (7 of 9 patients) most frequently. One patient was treated with methotrexate, and one with IVIG. CONCLUSIONS: Induction therapy used in clinical practice is effective and mainly well-tolerated in NSVN. Our data do not support an overall advantage of cyclophosphamide over corticosteroid monotherapy. Controlled trials comparing the effectiveness of induction and maintenance therapy in NSVN are warranted. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s42466-022-00198-5. |
format | Online Article Text |
id | pubmed-9377119 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-93771192022-08-16 Single-center experience of induction therapy in non-systemic vasculitic neuropathy Schneider, Christian Wassermann, Meike K. Fink, Gereon R. Lehmann, Helmar C. Neurol Res Pract Research Article BACKGROUND: No controlled studies for non-systemic vasculitic neuropathy treatment exist (NSVN). We compared the treatment response to induction therapy commonly used in clinical practice in NSVN. METHODS: In this retrospective single-center study, 43 patients with biopsy-proven NSVN were analyzed. Patients were subdivided into groups depending on their initial treatment. Relapse rates, changes of motor and sensory symptoms, adverse events, predictors of relapses, and second-line treatment were compared. RESULTS: Initial treatment regimens were corticosteroid monotherapy, cyclophosphamide monotherapy, pulsed corticosteroid therapy, and combination therapy. Discontinuation due to adverse events occurred in 6 of 43 patients. Clinical data did not differ between treatment groups. Within 12 months, 24.3% of patients relapsed. The median time to relapse was 4 (1.5, 6) months. No relapse occurred in the combination therapy group. However, there was no statistically significant difference in relapse-free survival between treatment groups (p = 0.58). Neither clinical data nor biopsy analysis predicted relapses sufficiently. As a second-line treatment, cyclophosphamide as mono- or combination therapy was used (7 of 9 patients) most frequently. One patient was treated with methotrexate, and one with IVIG. CONCLUSIONS: Induction therapy used in clinical practice is effective and mainly well-tolerated in NSVN. Our data do not support an overall advantage of cyclophosphamide over corticosteroid monotherapy. Controlled trials comparing the effectiveness of induction and maintenance therapy in NSVN are warranted. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s42466-022-00198-5. BioMed Central 2022-08-15 /pmc/articles/PMC9377119/ /pubmed/35965348 http://dx.doi.org/10.1186/s42466-022-00198-5 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Research Article Schneider, Christian Wassermann, Meike K. Fink, Gereon R. Lehmann, Helmar C. Single-center experience of induction therapy in non-systemic vasculitic neuropathy |
title | Single-center experience of induction therapy in non-systemic vasculitic neuropathy |
title_full | Single-center experience of induction therapy in non-systemic vasculitic neuropathy |
title_fullStr | Single-center experience of induction therapy in non-systemic vasculitic neuropathy |
title_full_unstemmed | Single-center experience of induction therapy in non-systemic vasculitic neuropathy |
title_short | Single-center experience of induction therapy in non-systemic vasculitic neuropathy |
title_sort | single-center experience of induction therapy in non-systemic vasculitic neuropathy |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9377119/ https://www.ncbi.nlm.nih.gov/pubmed/35965348 http://dx.doi.org/10.1186/s42466-022-00198-5 |
work_keys_str_mv | AT schneiderchristian singlecenterexperienceofinductiontherapyinnonsystemicvasculiticneuropathy AT wassermannmeikek singlecenterexperienceofinductiontherapyinnonsystemicvasculiticneuropathy AT finkgereonr singlecenterexperienceofinductiontherapyinnonsystemicvasculiticneuropathy AT lehmannhelmarc singlecenterexperienceofinductiontherapyinnonsystemicvasculiticneuropathy |