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Interferon beta-1a as an investigational treatment for CIDP

From the Department of Neurology, Dupuytren University Hospital, Limoges, France (Drs. Vallat, Magy, and Tabaraud); Department of Clinical Neurological Sciences, Victoria Hospital, London, Ontario, Canada (Dr. Hahn); Federation of Neurology, Mazarin, Salpétrière Hospital, Paris, France (Drs. Léger and Bouche); Department of Neurology, Massachusetts General Hospital, Boston, MA (Dr. Cros); and Biostatistics and Medical Informatics Department, Faculty of Medicine, Dupuytren University Hospital, Limoges, France (Dr. Preux).

Address correspondence and reprint requests to Dr. Jean-Michel Vallat, Service de Neurologie, CHU Dupuytren, Limoges, France; e-mail: vallat{at}unilim.fr

A prospective, multicenter, open-label study was conducted to determine the safety and efficacy of intramuscular (IM) interferon beta-1a (IFNß-1a) (Avonex) for treatment of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Eligible patients received IM IFNß-1a 30 µg once weekly for 6 months. Safety and tolerability were evaluated by reporting of adverse events, measurement of vital signs, and results of blood chemistry, hematology, and urinalysis. The primary efficacy end points were changed from baseline to month 6 on a quantitative Neurologic Disability Score (NDS), a clinical grading (CG) scale, and grip strength (GS) measures. Electrophysiologic measurements were performed at baseline and month 6. A total of 20 treatment-resistant patients with CIDP were enrolled in the study. The tolerability of IFNß-1a in patients with CIDP was similar to that seen with its use in MS. There were no serious adverse events, and no patients discontinued treatment due to adverse events. Seven patients (35%) showed clinical improvement, 10 (50%) had stable disease, and 3 (15%) continued to deteriorate. Significant improvements from baseline were observed in NDS in both the intent-to-treat and per protocol analyses (p=0.0005). For CG, significant improvement from baseline was observed in the per protocol analysis (p<0.05) but not in the intent-to-treat analysis. There was no significant effect of treatment on GS. Clinical improvement was not dependent on age, gender, clinical form of CIDP, or duration of symptoms. Electrophysiologic data showed improvements in mean median, ulnar, and tibial motor nerve potential areas. There was no correlation between clinical improvement and electrophysiologic data. The promising results of this study, especially given the refractory nature of the patient population, suggest that a larger placebo-controlled study should be performed to further evaluate the efficacy of IM IFNß-1a for the treatment of CIDP.

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