Electronic Monitoring of Disease Activity in Patients With Chronic Inflammatory Demyelinating Polyneuropathy (EMDA CIDP)

A Prospective Study to Evaluate the Usefulness of Electronically Captured Wearable Data to Assess Disease Activity in CIDP (Chronic Inflammatory Demyelinating Polyneuropathy) Patients Undergoing IVIG (Intravenous Immunoglobulin) Treatment.

This clinical, prospective study aims to evaluate the usefulness of electronically captured wearable data to assess disease activity in CIDP (chronic inflammatory demyelinating polyneuropathy) patients undergoing IVIG treatment. Close clinical monitoring will complement smartwatch-acquired data to shed light on different patient clusters and end-of-dose phenomena.

Study Overview

• Status: Completed
• Conditions: CIDP
• Intervention / Treatment: Device: Smartwatch (Withings Scanwatch)

Detailed Description

CIDP is a rare chronic neurological condition that leads to a considerable patient burden. As symptoms are often challenging to monitor, finding an individually optimal treatment regimen can be challenging. Additionally, patients receiving treatment often describe individual end-of-dose-phenomena, frequently leading to uncertainty regarding treatment intervals. Digital smartwatch-based measurements could add high-frequency real-world data to the picture and thus improve the understanding of individual disease courses.

Consequently, this study aims to evaluate different digital measurements and blood-based analyses to monitor disease activity in CIDP patients treated with intravenous immunoglobulins. Firstly, digital and blood-based measures will be compared to subjective patient reports and established clinical scores. Secondly, explorative analyses will aim to understand the longitudinal disease course and fluctuations thereof.

Data captured by the used smartwatches (Withings Scanwatch) includes activity-related data (step count, minutes in certain intensity levels), basic cardiovascular measurements such as heart rate, and sleep-related data (total time asleep, sleep quality, etc.). Blood-based measurements include serum neurofilament-light-chain (sNfL), glial fibrillary acidic protein (GFAP) and proteomic data. The investigators aim is to show can show whether therapy-dependent activity patterns, such as the end-of-dose phenomenon, are reflected in the recorded data.

Optionally, the digital signatures of CIDP patients will be compared to these of healthy controls wearing the smartwatch.

Patients were recruited in Düsseldorf and Münster.

• Study Type: Observational
• Enrollment (Actual): 46

Contacts and Locations

Study Locations

• Germany
  • Northrhine-Westphalia
    • Duesseldorf, Northrhine-Westphalia, Germany, 40225
      • Medical Faculty, Heinrich-Heine-University
    • Münster, Northrhine-Westphalia, Germany, 48149
      • University Hospital Münster, Department of Neurology

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

CIDP patients with ongoing standard of care IVIG treatment, older or 18 years

Description

Inclusion Criteria:

• IVIG treated ? (all criteria a-c must be met):

  1. Documented evidence of objective response to IVIG, with clinically meaningful improvement. Clinically meaningful improvement is defined as one of the following: ≥1-point decrease in adjusted INCAT score, ≥4 points increase in I-RODS total score, ≥3 points increase in MRC Sum score, ≥8 kilopascal improvement in mean grip strength (one hand), or an equivalent improvement based on information documented in medical records and per the PI's judgement.
  2. Must be on stable IVIG therapy, defined as no change greater than 10% in frequency or dose of immunoglobulin therapy or corticosteroids within 8 weeks prior to screening
  3. Evidence of clinically meaningful deterioration on interruption or dose reduction of IVIG therapy within 24 months prior to screening, determined by clinical examination or medical records. Clinically meaningful deterioration is defined as one of the following: ≥1-point increase in adjusted INCAT score, decrease in I-RODS total score ≥4 points, decrease in MRC Sum score ≥3, mean grip strength worsening of ≥8 kilopascals (one hand), or an equivalent deterioration based on information from medical records and at the PI's judgement.

Exclusion Criteria:

• unable to use smartwatch or/and smartphone device

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
CIDP patients; CIDP patients with ongoing standard of care IVIG treatment	Device: Smartwatch (Withings Scanwatch); All-day monitoring of patients via smartwatch

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Inflammatory Rasch-built Overall Disability Scale (I-RODS)	24-item scale, with each item representing a common, daily activity minimum value: 0 points, maximum value: 48 points, best result: 48 points	Screening + Baseline (V1), After 3 months (V2), After 6 months (V3)
Change in Inflammatory Neuropathy Cause and Treatment (INCAT) disability score	minimum value: 0 points, maximum value: 10 points, best result: 0 points	Screening + Baseline (V1), After 3 months (V2), After 6 months (V3)
Change in Grip strength		Screening + Baseline (V1), After 3 months (V2), After 6 months (V3)
Change in Medical Research Council (MRC)-Sumscore	minimum value: 0 points, maximum value: 60 points, best result: 60 points	Screening + Baseline (V1), After 3 months (V2), After 6 months (V3)
Change in Subjective occurrence of end-of-dose phenomena/wearing off		Screening + Baseline (V1), After 3 months (V2), After 6 months (V3)
Change in Quality of life (QoL)	The Quality of Life Questionnaire (QoL) is an instrument for measuring patients' subjective quality of life in a wide range of specific areas	Screening + Baseline (V1), After 3 months (V2), After 6 months (V3)
Change in Pittsburgh Sleep Quality Index (PSQI)		Screening + Baseline (V1), After 3 months (V2), After 6 months (V3)
Change in Blood analysis (levels of sNfl, serum proteomics)		Screening + Baseline (V1), After 3 months (V2), After 6 months (V3)
Questionnaire about smartwatch usage		After 6 months (V3)
Wearing time of smartwatch (daily)		180 days
Longitudinal development of activity parameter: step count		180 days
Longitudinal development of activity parameter: approximate distance traveled (meter)		180 days
Longitudinal development of activity parameter: duration of soft activity (seconds) defined by Withings	Examples for soft activity: Sleeping, Sitting quietly, Walking slowly, Typing on a computer keyboard while seated, Watching television, Doing the dishes	180 days
Longitudinal development of activity parameter: duration of moderate activity (seconds) defined by Withings	Examples for moderate activity: Walking fast, Cleaning (vacuuming, washing windows, etc.), Playing doubles tennis or badminton, Taking a bike ride, Gardening	180 days
Longitudinal development of activity parameter: duration of intense activity (seconds) defined by Withings	Examples for intense activity: Hiking, Running, Carrying heavy loads, Riding a bike, Playing football,baseball, or tennis (singles), Playing jump rope	180 days
Longitudinal development of activity parameter: sum of all active time (seconds)		180 days
Longitudinal development of activity parameter: approximate calories burned		180 days
Longitudinal development of sleep parameter: time awake (seconds)		180 days
Longitudinal development of sleep parameter: number of times user woke up		180 days
Longitudinal development of sleep parameter: time to sleep (seconds)		180 days
Longitudinal development of sleep parameter: total time in bed (seconds)		180 days
Longitudinal development of sleep parameter: total time asleep (seconds)		180 days
Longitudinal development of sleep parameter: ratio of sleep/time in bed		180 days
Longitudinal development of sleep parameter: time spent in bed before falling asleep (seconds)		180 days
Longitudinal development of sleep parameter: time awake after first falling asleep (seconds)		180 days
Longitudinal development of sleep parameter: Withings Sleep score	Defined by Withings as follows: It measures every night's sleep and provides a score out of 100 points based on 4 key inputs: Duration (total time spent sleeping); Depth (part of night spent in restorative phases and deep sleep); Regularity (consistency between your bed- and rise-times); Interruptions (time spent awake)	180 days
Longitudinal development of cardiovascular parameter: average heartrate		180 days
Longitudinal development of cardiovascular parameter: maximal heartrate		180 days
Longitudinal development of cardiovascular parameter: minimum heartrate		180 days
Longitudinal development of cardiovascular parameter: time in light heartrate zone (seconds)	Light heartrate zone is defined by Withings as follows: from 0% inclusive to 50% exclusive of maximum heart rate.	180 days
Longitudinal development of cardiovascular parameter: time in moderate heartrate zone (seconds)	Moderate heartrate zone is defined by Withings as follows: from 50% included to 70% excluded of maximal heart rate.	180 days
Longitudinal development of cardiovascular parameter: time in intense heartrate zone (seconds)	Intense heartrate zone is defined by Withings as follows: from 70% included to 90% excluded of maximal heart rate.	180 days
Longitudinal development of cardiovascular parameter: time in maximal heartrate zone (seconds)	Maximal heartrate zone is defined by Withings as follows: from 90% included to 100% included of maximal heart rate.	180 days
Number and time of Irregular 1-channel ECGs (according to Withings algorithm)		180 days

Collaborators and Investigators

• Sponsor: Heinrich-Heine University, Duesseldorf

Study record dates

Study Major Dates

• Study Start (Actual): January 20, 2023
• Primary Completion (Actual): July 16, 2024
• Study Completion (Actual): July 16, 2024

Study Registration Dates

• First Submitted: January 10, 2023
• First Submitted That Met QC Criteria: February 1, 2023
• First Posted (Actual): February 13, 2023

Study Record Updates

• Last Update Posted (Actual): July 17, 2024
• Last Update Submitted That Met QC Criteria: July 16, 2024
• Last Verified: July 1, 2024

More Information

Terms related to this study

• Keywords: Immune System Diseases; Nervous System Diseases; Polyneuropathies; Autoimmune Diseases; Neuromuscular Diseases; Smartwatch; neuropathy; Peripheral Nervous System Diseases; Demyelinating Diseases; Autoimmune Diseases of the Nervous System; Polyradiculoneuropathy; Polyradiculoneuropathy, Chronic Inflammatory Demyelinating; end of dose phenomenon
• Additional Relevant MeSH Terms: Pathologic Processes; Nervous System Diseases; Immune System Diseases; Autoimmune Diseases of the Nervous System; Demyelinating Diseases; Autoimmune Diseases; Disease Attributes; Neuromuscular Diseases; Peripheral Nervous System Diseases; Polyradiculoneuropathy; Chronic Disease; Polyneuropathies; Polyradiculoneuropathy, Chronic Inflammatory Demyelinating
• Other Study ID Numbers: 2022-1881

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No