Outcome measures and biomarkers in chronic inflammatory demyelinating polyradiculoneuropathy: from research to clinical practice

Expert Rev Neurother. 2021 Jul;21(7):805-816. doi: 10.1080/14737175.2021.1944104. Epub 2021 Jul 2.


Introduction: Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an immune-mediated syndrome characterized clinically by weakness and/or numbness that evolves over 2 months or more. The heterogeneity of clinical features necessitates an individualized approach to disease monitoring that takes lessons learned from clinical trials and applies them to clinical practice.Areas covered: This review discusses the importance of clinimetrics and biomarkers in CIDP diagnosis and disease monitoring. Highlighted are the challenges of defining responses to immunotherapy, the usefulness, and limitations of utilizing evidence-based clinical outcome measures during routine clinical care, and the evolving understanding of how diagnostic and disease activity biomarkers may reshape our treatment and disease monitoring paradigms.Expert opinion: Although disability and impairment outcome measures are commonly used in CIDP to indicate disease status, the nonspecific nature of these metrics limits the ability to attribute a change in any given metric to a change in CIDP. This interpretive challenge may be magnified by inconsistencies in the direction of change as well as a strong placebo effect. There is a need to improve our understanding of minimally important changes in existing outcome measures as a means to personalize treatment and to better assess disease activity status with biomarker discovery.

Keywords: Chronic inflammatory demyelinating polyradiculoneuropathy; biomarkers; clinical outcome measures; diagnosis; disability; disease activity; impairment; minimal clinically important difference.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Biomarkers
  • Humans
  • Immunologic Factors
  • Immunotherapy
  • Outcome Assessment, Health Care
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating* / diagnosis
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating* / therapy


  • Biomarkers
  • Immunologic Factors