Health-related quality of life in chronic inflammatory neuropathies: A systematic review

Abstract

Chronic inflammatory neuropathies represent a heterogeneous group of disorders which affect patients' functional status and quality of life. We conducted a systematic review of the scientific literature on the effects of both disease and treatment interventions on health-related quality of life (HRQoL) in this patient population. The available data are limited, as few studies have systematically considered HRQoL in patients with inflammatory neuropathies. Moreover, in treatment trials, HRQoL measures have exclusively been used as secondary outcome measures. There is some evidence suggesting that baseline pre-treatment HRQoL reports are lower in patients with chronic inflammatory neuropathy than in age and gender-matched controls. Following treatment interventions, improvements in self-reported measures were consistently documented in the physical domain of HRQoL, which in turn correlated with improvements in traditional strength and functional scales. The impact of available treatments on the quality of life of patients with inflammatory neuropathies remains largely under-investigated. Interestingly, recent, although limited evidence from generic HRQoL measures may partly or completely contradict the results found with the primary, traditional outcome measures used (rituximab for anti-MAG neuropathy; immunoglobulins versus corticosteroids for chronic inflammatory demyelinating polyneuropathy). Similarly, HRQoL measures may suggest superiority, rather than equivalence, of certain drug administration methods (subcutaneous over intravenous immunoglobulins). Further research is needed to assess HRQOL in patients with untreated chronic inflammatory neuropathies in comparison to normative values, as well as precisely quantify treatment benefit. The role of both generic and disease-specific HRQoL measures in the evaluation of patients with chronic inflammatory neuropathies is also worthy of further consideration.

Neuropsychiatric manifestations in inflammatory neuropathies: A systematic review

“…In conclusion, neuropsychiatric aspects can be of major importance in patients with inflammatory neuropathies; their occurrence has the potential to influence the severity of the clinical presentation, its functional impact, and health‐related quality of life . This contrasts with the paucity of studies in this area.…”

“…The incidence, characteristics, implications, and consequences of such disturbances are generally not well known, routinely assessed, or adequately considered in routine care of patients with inflammatory neuropathy. Neuropsychiatric symptoms may also add significant burden to health‐related quality of life and have a negative impact on its clinical manifestations, and can include pain and impaired sensory function and motor performance . Furthermore, it is likely that these aspects may have significant implications for therapeutic efficacy and its objective assessment.…”

Chronic Acquired Polyneuropathy Patient Reported Index (CAPPRI) in chronic inflammatory demyelinating polyradiculoneuropathy

“…Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a chronic autoimmune, slowly progressive or relapsing‐remitting disease, which usually manifests as symmetric proximal and distal weakness and sensory disturbance in the limbs . Previous studies have found that quality of life (QoL) is impaired in CIDP patients …”

“…1 Previous studies have found that quality of life (QoL) is impaired in CIDP patients. [2][3][4] In most of the studies that have assessed QoL in patients with CIDP generic health-related QoL questionnaires were used. 2,4,5 However, it is believed that these questionnaires are usually unable to capture all specific characteristics of the specific disease.…”

“…[2][3][4] In most of the studies that have assessed QoL in patients with CIDP generic health-related QoL questionnaires were used. 2,4,5 However, it is believed that these questionnaires are usually unable to capture all specific characteristics of the specific disease. The Chronic Acquired Polyneuropathy Patient-Reported Index (CAPPRI) is a unidimensional 15-item patient-reported index with three response categories, constructed and validated in a multi-center study in the United States in patients with chronic immune-mediated polyneuropathies including CIDP.…”