Vigorimeter grip strength in CIDP: a responsive tool that rapidly measures the effect of IVIG--the ICE study.

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.

• Authors: E K Vanhoutte, N Latov, C Deng, K Hanna, R A C Hughes, V Bril, M C Dalakas, P Donofrio, P A van Doorn, H-P Hartung, I S J Merkies
• Journal: European journal of neurology (Eur J Neurol) Vol. 20 Issue 5 Pg. 748-55 (May 2013) ISSN: 1468-1331 [Electronic] England
• PMID: 22891893 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: © 2012 The Author(s) European Journal of Neurology © 2012 EFNS.

Chemical References

• Immunoglobulins, Intravenous
• Immunologic Factors

Topics

• Disability Evaluation
• Double-Blind Method
• Hand Strength (physiology)
• Humans
• Immunoglobulins, Intravenous (therapeutic use)
• Immunologic Factors (therapeutic use)
• Polyradiculoneuropathy, Chronic Inflammatory Demyelinating (drug therapy, physiopathology)