Presentation (CTI)

OBJECTIVES: Chronic inflammatory demyelinating polyneuropathy (CIDP) is an immune-mediated neuropathy characterized by motor and sensory nerve demyelination. CIDP patients may be predisposed to infections due to their autoimmune condition. Steroids commonly used in CIDP treatment are associated with adverse outcomes, yet the infection risk attributable to steroids in CIDP remains unclear. This study explores the relationship between oral corticosteroid use (OCS) and the risk of serious infections in CIDP.
METHODS: We analyzed data from Komodo claim dataset (January 2015 to March 2024) to identify CIDP patients with ≥3 claims with a diagnosis of CIDP and ≥1 nerve conduction test. Time-varying mean daily OCS doses were calculated by dividing the total quantity of OCS collected during a 90-day window before the start of each follow-up period by the length of the window. OCS quantities were converted to prednisone equivalents and daily doses were categorized into: ‘no OCS’, ‘low OCS dose’ (≤10 mg/day) and ‘high OCS dose’ (>10 mg/day).
RESULTS: Among 6,305 CIDP patients, low OCS dose was associated with a 51% increased odds of serious infection compared to no OCS use (p = 0.002), while high dose use showed a 62% increase (p = 0.002). By the twelfth quarter of follow-up, the mean probability of serious infection increased from < 10% at baseline to 22% in the no OCS use, 40% in the low use, and 60% in the high use groups.
CONCLUSIONS: OCS use in CIDP correlates with a dose- and time-dependent increased risk of serious infections. Even low doses are associated with increased risk, emphasizing the need for alternative therapies or infection mitigation strategies in this population.