1. Vigorimeter grip strength in CIDP: a responsive tool that rapidly measures the effect of IVIG - the ICE study.
- Author
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Vanhoutte, E. K., Latov, N., Deng, C., Hanna, K., Hughes, R. A. C., Bril, V., Dalakas, M. C., Donofrio, P., Doorn, P. A., Hartung, H.‐P., and Merkies, I. S. J.
- Subjects
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GRIP strength , *GLOBULINS , *PLACEBOS , *INFLAMMATION , *NEUROPATHY - Abstract
Background and purpose In a recent trial in patients with chronic inflammatory demyelinating polyradiculoneuropathy ( CIDP), the ICE study, grip strength measurement captured significantly more improvement in patients receiving immune globulin ( IGIV- C) intravenously than in those receiving placebo. Methods We conducted a systematic analysis to determine the sensitivity of grip strength as an indicator of meaningful clinical changes in CIDP. Results A randomized double-blind trial was undertaken in 117 CIDP patients who received IGIV-C or placebo every 3 weeks for up to 24 weeks. Grip strength and inflammatory neuropathy cause and treatment (INCAT) disability scores were assessed at each visit, and the responsiveness of each scale was compared. A minimum clinically important difference cut-off value for grip strength (>8 kPa) and INCAT score (>1 point) was applied to assess the proportion of responders to IGIV-C versus placebo. This analysis showed that grip strength demonstrated significant improvement earlier (as early as day 16) than the INCAT disability scale in patients receiving IGIV-C compared with placebo. A significantly higher proportion of improvers were seen in the IGIV-C group (37.5%-50.9%) than in the placebo group (21.1%-25.9%) for grip strength at day 16, week 3, week 6 and the end of the first period. Also, grip strength showed within the first 6 weeks in the placebo group significantly more patients with a clinically meaningful deterioration (>8 kPa), compared with the INCAT (>1-point deterioration) findings. Conclusions Grip strength can be considered a sensitive tool for assessing clinically relevant changes in patients with CIDP. Its use in daily practice is suggested. [ABSTRACT FROM AUTHOR]
- Published
- 2013
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