Introduction: Autoimmune demyelinating polyneuropathy is a fairly rare form of the disease in which the immune system attacks its own peripheral nervous system and causes demyelination, possibly even loss of axons. With early diagnosis and appropriate treatment, long-term nerve damage and functional impairment can be prevented. Most patients respond well to treatment with immunoglobulins that have been administered intravenously in the past, and subcutaneous therapy has been gaining ground in recent years. It improves the quality of life for most patients and limits the occurrence of serious side effects. Purpose: We wanted to quantitatively measure the effectiveness of treatment of demyelinating polyneuropathy with subcutaneous administration of immunoglobulins and compare the results with the results during treatment with intravenous immunoglobulins. Methods: We monitored the course of subcutaneous treatment of 11 patients (diagnosed with chronic inflammatory demyelinating polyneuropathy or multifocal motor neuropathy) for up to six months. Functional tests (get up and go test, overall disability sum score), INCAT sensory sum score, dynamometry (grip and pinch strength) and muscle strength testing according to the MRC scale were performed with the introduction of a new therapy, the first, third and sixth month of subcutaneous therapy with immunoglobulins. The test results at the introduction and after 3 and 6 months of therapy were statistically analyzed with a bilateral t-test: parametric data with the D'Agostino & Pearson test and non-parametric with the Wilcoxon signed-rank test of predicted ranks. The change in the general condition of the subject was determined on the basis of at least two clinically significant changes in measurements (deviations of at least 25 %) in the absence of another type of clinically significant change. Results: The results of functional tests, INCAT sensory evaluation, dynamometry, and muscle strength measured in subcutaneous therapy did not differ statistically from values monitored in time of intravenous immunoglobulin therapy (the values measured at introduction of a new therapy). The results show an improvement in the condition of 5/11 patients, a deterioration in 1/11 and an unchanged condition of the other 5 patients. Discussion and conclusion: Based on the results of statistical analysis and clinical changes, we conclude that subcutaneous and intravenous therapy in patients with demyelinating polyneuropathy are comparable. Differences between individuals are present, so dose individualization and route of administration are important when choosing therapy. In Slovenia, only treatment with intravenous immunoglobulins was previously established for such patients, and with the positive results of our research, we can expect the introduction of subcutaneous therapy in this field.
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