Presentation (CTI)

OBJECTIVES: Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a rare autoimmune disease associated with substantial clinical and economic burden. This analysis aimed to describe the epidemiology, treatment patterns, and healthcare costs of CIDP patients in Italian clinical practice.
METHODS: This retrospective observational analysis used administrative healthcare databases covering ~6 million individuals (01/2003-12/2025). Adult CIDP patients were identified through active copayment exemption code (RF0180). Annual incidence and prevalence for 2024 were estimated; a sensitivity analysis including ICD-9-CM code 357.81 as an additional inclusion criterion was performed. Patients were stratified into CIDP-treated and untreated cohorts, and characterized for demographics, comorbidities, drug utilization, and healthcare costs.
RESULTS: Estimated prevalence was 9.8 (16.8 in sensitivity analysis) per 100,000 individuals; annual incidence was 13.4 per 1,000,000 individuals. Overall, 588 CIDP patients were included; 451 (77%) were treated and 137 (23%) untreated. Mean age was 57.8±14.9 years, 65.5% were male. Among patients with ≥12 months of characterization (N=424), hypertension (49%), depression (15%), and diabetes (12%) were the most common comorbidities. Treated patients showed a trend toward higher comorbidity burden. Among treated patients, 363 (80.5%) received corticosteroids; 214 (47.5%) immunoglobulins (Ig), including 175 (39%) intravenous and 84 (19%) subcutaneous Ig; 94 (21%) immunosuppressants; 26 (6%) rituximab; and 27 (6%) plasmapheresis. Overall, 212 patients (47%) initiated second-line treatment after 18.1±27.9 months. Among patients initially treated with corticosteroids/immunosuppressants (N=287), 21% subsequently received Ig after 14.4±20.7 months. Among Ig-treated patients, 72% switched to or added another treatment after 14.9±21.5 months. Mean total direct costs during first-year follow-up were €7,951 per patient, mainly driven by drug prescriptions (€6,276), 82% attributable to Ig therapies. Among Ig-treated patients, mean total direct costs were €22,918 during the first year and decreased over time.
CONCLUSIONS: CIDP management in Italian clinical practice is characterized by frequent treatment modifications, reflecting management complexity, and by substantial healthcare costs.