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Two comparative assessments of intravenous immunoglobulin therapy switching patterns in the treatment of chronic inflammatory demyelinating polyneuropathy in the US

Authors Guptill JT, Runken MC, Eaddy M, Lunacsek OE, Fuldeore RM, Blanchette CM, Zacherle E, Noone JM

Received 8 September 2018

Accepted for publication 1 March 2019

Published 30 April 2019 Volume 2019:13 Pages 649—655

DOI https://doi.org/10.2147/PPA.S185852

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 2

Editor who approved publication: Dr Johnny Chen


Jeffrey T Guptill,1 M Chris Runken,2 Michael Eaddy,3 Orsolya E Lunacsek,4 Rupali M Fuldeore,4 Christopher M Blanchette,5 Emily Zacherle,5 Joshua M Noone5

1Department of Neurology, Duke University, Durham, NC, USA; 2Grifols SSNA, Research Triangle Park, Durham, NC, USA; 3Scientific Consulting, Xcenda, Palm Harbor, FL, USA; 4Real-World Evidence, Xcenda, Palm Harbor, FL, USA; 5Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA

Purpose: For chronic inflammatory demyelinating polyneuropathy (CIDP) patients, each branded intravenous immunoglobulin (IVIG) treatment differs in production processes, virus elimination, formulation, and composition. Given the limited availability of real-world data comparing IVIGs for CIDP, this study evaluated switching patterns between IVIG products in 2 separate retrospective databases.
Patients and methods: Two independent analytic teams retrospectively evaluated IVIG treatment-naïve patients with an ICD diagnosis code for CIDP. Study 1 used integrated healthcare claims from IMS LifeLink PharMetrics Plus™ and Study 2 used the Truven MarketScan® Database. All analyses were descriptive, with outcomes assessed during the 2-year post-index period.
Results: One-quarter of IVIG patients switched therapies within the 2-year study period. In both studies, switching rates were lowest for IVIG-G (Gamunex®-C) (Study 1: 9.8%, Study 2: 8.9%), followed by IVIG-F (Flebogamma®) (Study 1: 25.0%, Study 2: 18.2%), and highest for IVIG-other (Octagam®/Gammaplex®) (Study 1: 50.0%, Study 2: 33.3%). When patients were switched, most switched to IVIG-G (Study 1: 51.6%, Study 2: 54.3%).
Conclusion: The small proportion of CIDP switchers in 2 independent studies suggests that IVIG therapy is generally well tolerated. However, differences existed in switch rates for different IVIG products. The reason for low switching rates could not be assessed in this study; therefore, further studies are required to detect possible relevant differences in effectiveness and tolerability.

Keywords: intravenous immunoglobulin, chronic inflammatory demyelinating polyneuropathy, treatment patterns

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