4.7 Article

Inflammatory Neuropathy Cause and Treatment overall disability score prevalence and determinants of pain in chronic inflammatory demyelinating polyneuropathy: Results from the German INHIBIT registry

Journal

EUROPEAN JOURNAL OF NEUROLOGY
Volume 29, Issue 7, Pages 2109-2120

Publisher

WILEY
DOI: 10.1111/ene.15341

Keywords

chronic inflammatory demyelinating polyneuropathy; depression; fatigue; pain; quality of life; registry

Funding

  1. Biogen
  2. Novartis
  3. Celgene (BristolMyersSquibb)
  4. Teva
  5. Eisai
  6. Klaus Tschira Foundation
  7. Hertie Foundation
  8. Ruhr-University
  9. Bochum (FoRUM-program)
  10. Georgius Agricola Stiftung Ruhr
  11. Ruhr-University, Bochum (FoRUM-program)
  12. Novartis AG
  13. Sanofi
  14. Eisai GmbH
  15. DFG
  16. BMBF
  17. DGUV
  18. Leitmarkt NRW
  19. Heimer Foundation
  20. Genzyme
  21. Ambulanzpartner
  22. Teva Pharmaceutical Industries Ltd
  23. Biogen Idec
  24. Bayer Schering Pharma
  25. Merck Serono
  26. German Social Accident Insurance (DGUV)

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This study investigated the prevalence, characteristics, and contribution to disability of pain, fatigue, and depression in patients with chronic inflammatory demyelinating polyneuropathy (CIDP). The results showed that these three factors have a significant impact on the quality of life of patients, and sensory dysfunction is associated with neuropathic pain. Therefore, it is important to consider these factors in therapeutic interventions.
Background and purpose Pain, fatigue and depression in chronic inflammatory demyelinating polyneuropathy (CIDP) are often underestimated, as the focus lies on sensorimotor dysfunction and gait instability. The aim of this study was to investigate their prevalence, characteristics and contribution to disability in a prospective cohort of 84 patients with CIDP. Methods Pain, fatigue, depression and quality of life were measured using the Pain Detect Questionnaire, Krupp's Fatigue Severity Scale, Beck Depression Inventory II and the German Short-Form 36 Health Survey. Sensorimotor deficits and disability were assessed using the Inflammatory Neuropathy Cause and Treatment overall disability score, the Rasch-built Overall Disability Scale, the Medical Research Council sum score and the Inflammatory Neuropathy Cause and Treatment sensory sum score. The interrelation between the five factors was assessed using analysis of variance and linear regression analysis. Results Pain was reported in 62%, mostly of moderate and severe intensity, whereas pain characteristics indicated neuropathic pain (NP) in 29%. Sensory dysfunction was stronger in NP patients compared to pain-free patients (p = 0.001). Pain of any type, especially NP, was associated with more pronounced fatigue symptoms (p = 0.010). Depressive symptoms were more frequent in patients with pain compared to the pain-free patients (61% vs. 33%, p = 0.02) and were more severe and frequent in NP than in non-NP patients (p = 0.005). Patients with pain had a worse physical quality of life than pain-free patients (p = 0.001). Conclusion Pain, depression and fatigue are relevant disability factors in CIDP affecting quality of life. Sensory dysfunction is associated with NP. Therefore, evaluation of CIDP-related disability should include pain and sensory function for adequate monitoring of therapeutic interventions.

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