{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:47:29Z","timestamp":1790790449013,"version":"4.1.0"},"reference-count":47,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T00:00:00Z","timestamp":1747094400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction\/Aims<\/jats:title><jats:p>Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a potentially disabling autoimmune neuropathy. Approximately 20% of patients are refractory to first\u2010line treatments necessitating second\u2010line options with limited evidence and potential adverse effects. This study evaluates the efficacy of mycophenolate mofetil (MMF) in refractory CIDP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective case\u2013control study of MMF plus IVIg \u00b1 corticosteroids (MMF cohort, <jats:italic>n<\/jats:italic>\u2009=\u200911) versus IVIg only treatment (comparator cohort, <jats:italic>n<\/jats:italic>\u2009=\u200933) for CIDP in a single institution is reported. IVIg dosing, day care unit (DCU) utilization, disease specific outcome measures, and adverse events were recorded before and 1\u2009year after MMF initiation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Median Medical Research Council Sum Score (MRC\u2010SS) and Inflammatory Rasch\u2010built Overall Disability Scale logit score (I\u2010RODS) were lower, and DCU utilization was greater, in the MMF cohort than the comparator cohort prior to the introduction of MMF, representing this refractory patient group. Clinical outcomes improved with MMF: median MRC\u2010SS improved from 58 to 68.5 (<jats:italic>p<\/jats:italic>\u2009=\u20090.012) and median I\u2010RODS improved from 47 to 78 (<jats:italic>p<\/jats:italic> value\u2009=\u20090.028). There was a fiscally meaningful reduction in median IVIg dose and a reduction in DCU utilization from 2.89\u2009days\/month to 1.65\u2009days\/month (<jats:italic>p<\/jats:italic> value\u2009=\u20090.042). Cost savings averaged \u00a338,432 per patient\/year. MMF was well tolerated at 1 to 1.5\u2009mg twice daily.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>MMF is a well\u2010tolerated and potentially effective adjunctive medication in CIDP patients with suboptimal response to first\u2010line therapies. In refractory patients, MMF addition was associated with improvements in outcome measures and meaningful cost reductions. Further trials are required for confirmation.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mus.28436","type":"journal-article","created":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T06:02:56Z","timestamp":1747116176000},"page":"250-257","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Mycophenolate Facilitates Improvement in Outcome Measures in Treatment Resistant Chronic Inflammatory Demyelinating Polyradiculoneuropathy"],"prefix":"10.1002","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9069-4656","authenticated-orcid":false,"given":"Shamim","family":"Miah","sequence":"first","affiliation":[{"name":"Centre for Neuromuscular Diseases National Hospital for Neurology and Neurosurgery  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Japzon","sequence":"additional","affiliation":[{"name":"Centre for Neuromuscular Diseases National Hospital for Neurology and Neurosurgery  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amar","family":"Elsaddig","sequence":"additional","affiliation":[{"name":"Centre for Neuromuscular Diseases National Hospital for Neurology and Neurosurgery  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiwen","family":"Koay","sequence":"additional","affiliation":[{"name":"Centre for Neuromuscular Diseases National Hospital for Neurology and Neurosurgery  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Compton","sequence":"additional","affiliation":[{"name":"Centre for Neuromuscular Diseases National Hospital for Neurology and Neurosurgery  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael P.","family":"Lunn","sequence":"additional","affiliation":[{"name":"Centre for Neuromuscular Diseases National Hospital for Neurology and Neurosurgery  London UK"},{"name":"UCL Queen Square Institute of Neurology Faculty of Brain Sciences, University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aisling S.","family":"Carr","sequence":"additional","affiliation":[{"name":"Centre for Neuromuscular Diseases National Hospital for Neurology and Neurosurgery  London UK"},{"name":"UCL Queen Square Institute of Neurology Faculty of Brain Sciences, University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,13]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD010369.pub2"},{"issue":"7","key":"e_1_2_12_3_1","first-page":"493","article-title":"Long\u2010Term Treatment of Chronic Inflammatory Demyelinating Polyradiculoneuropathy With Plasma Exchange or Intravenous Immunoglobulin","volume":"88","author":"Choudhary P. 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Long\u2010Term Single Centre Experience of Cyclophosphamide Side Effects in the Treatment of Systemic Autoimmune Diseases","volume":"144","author":"Dan D.","year":"2014","journal-title":"Swiss Medical Weekly"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.3949\/ccjm.61.4.308"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/practneurol-2018-001899"},{"issue":"3","key":"e_1_2_12_17_1","first-page":"S3","article-title":"Phase 2 Efficacy and Safety of Riliprubart, a C1s\u2010Complement Inhibitor, in Chronic Inflammatory Demyelinating Polyneuropathy","volume":"29","author":"Querol L.","year":"2024","journal-title":"Journal of the Peripheral Nervous System"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/pn-2023-003708"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.35.8.1173"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474\u20104422(08)70299\u20100"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.51.6.1735"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-4598(199804)21:4<454::AID-MUS3>3.0.CO;2-8"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2004.05.014"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhepr.2022.100601"},{"issue":"3","key":"e_1_2_12_25_1","first-page":"S3","article-title":"Does Mycophenolate Mofetil Facilitate IGIV Withdrawal in CIDP? 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