Treatment polyradiculoneuropathy. Medical search. Frequent questions

Nerve ultrasound has been proven to be an accurate tool in diagnosing chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). (springer.com)
The aim of this study was to explore whether nerve ultrasound and its changing trend could predict the response to immune treatment in CIDP. (springer.com)
Nerve ultrasonography could help guide treatment strategies in patients with CIDP. (springer.com)
Short-term studies suggest that intravenous immunoglobulin might reduce disability caused by chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) but long-term effects have not been shown. (nih.gov)
117 patients with CIDP who met specific neurophysiological inflammatory neuropathy cause and treatment (INCAT) criteria participated in a randomised, double-blind, placebo-controlled, response-conditional crossover trial. (nih.gov)
This study, the largest reported trial of any CIDP treatment, shows the short-term and long-term efficacy and safety of IGIV-C and supports use of IGIV-C as a therapy for CIDP. (nih.gov)
The term chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) has been used to identify patients with a chronically progressive or relapsing symmetric sensorimotor disorder with cytoalbuminologic dissociation and interstitial and perivascular endoneurial infiltration by lymphocytes and macrophages. (medscape.com)
PHOENIX -- Subcutaneous efgartigimod PH20 SC shows efficacy and tolerability in the treatment of chronic inflammatory demyelinating polyneuropathy (CIDP), providing a convenient alternative to intravenous and other older treatments for this rare disease. (medscape.com)
Furthermore, "this is the first new treatment for CIDP in over 30 years, so it's very exciting. (medscape.com)
Efgartigimod, which is approved in its IV and subcutaneous forms for the treatment of myasthenia gravis , is a human IgG1 antibody Fc receptor blocker designed to reduce pathogenic IgG autoantibody levels, which may be drivers of pathogenesis in CIDP. (medscape.com)
For the ongoing phase 2 ADHERE trial, 322 patients with a diagnosis of CIDP and active disease who were either treatment-naive or receiving standard treatments were withdrawn from their treatments prior to day 1 of a run-in period of up to 12 weeks. (medscape.com)
The findings show that "efgartigimod-PH20, given as a 90-second subcutaneous injection once a week, was effective in treating patients with CIDP who had relapsed when taken off their previous treatment (IVIg or corticosteroids)," said Lewis. (medscape.com)
The study] then showed that the majority of patients, over 70%, maintained that improvement compared to placebo, where over 50% relapsed - most within 8 weeks, so the treatment, which reduces circulating immunoglobulin G by over 70%, is effective in treating CIDP," he added. (medscape.com)
Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is characterized by progressive weakness and sensory loss, often affecting patientsʼ ability to walk and perform activities of daily living independently. (aanem.org)
There is a lack of awareness and treatment of CIDP. (wikipedia.org)
Autoimmune neuropathies encompass acute forms such as Guillain-Barre syndrome (GBS) and its variants, as well as chronic forms including chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), multifocal motor neuropathy, and polyneuropathies associated with immunoglobulin M (IgM) monoclonal gammopathy and paraneoplastic neuropathies. (nursingcenter.com)
Investigators identified 3 records comparing IVIG and TPE efficacy in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). (pharmacytimes.com)
Based on the review, investigators concluded that TPE and IVIG are both viable treatment options for multiple autoimmune neurological disorders, including GBS, MG, CIDP, and encephalitis. (pharmacytimes.com)
Corticosteroids, plasma exchange, and intravenous immunoglobulin (IVIG) have been standard-of-care treatments for chronic inflammatory demyelinating polyneuropathy (CIDP) for more than 2 decades. (ahdbonline.com)
Despite guideline recommendations for best clinical practices, heterogeneity in patient presentation and the course of treatment for CIDP remains. (ahdbonline.com)
There is limited literature regarding the real-world treatment patterns of and costs associated with CIDP. (ahdbonline.com)
To analyze and describe the real-world treatment patterns of and economic burden associated with CIDP. (ahdbonline.com)
This retrospective cohort study evaluated the treatment patterns and CIDP-related healthcare costs over a 2-year follow-up period for patients with newly diagnosed CIDP who had commercial insurance, using claims data from the IMS LifeLink PharMetrics Plus Claims database between 2009 through 2014. (ahdbonline.com)
Treatment-naïve patients with newly diagnosed CIDP were evaluated for 2 years postdiagnosis, which captured the treatments used and the resource utilization. (ahdbonline.com)
Steroid therapy was initiated later and resulted in a shorter duration of treatment than other treatment options for patients with CIDP, which may reflect diagnostic uncertainty, disease severity or remission, therapeutic challenge to determine diagnosis, or the side-effect profile of steroids. (ahdbonline.com)
The use of steroids alone was the most common prescribed treatment for CIDP. (ahdbonline.com)
Investigations confirmed a demyelinating neuropathy, with nerve conduction studies fulfilling electrodiagnostic criteria for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). (bmj.com)
Background The aim of this study was to determine treatment response and whether it is associated with antibody titre change in patients with autoimmune nodopathy (AN) previously diagnosed as chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), and to compare clinical features and treatment response between AN and CIDP. (bmj.com)
Conclusions Distinguishing CIDP from AN is important, as patients with AN need a different treatment approach. (bmj.com)
CIDP is characterized by weakness, sensory loss, and areflexia and presents with a relapsing-remitting or chronic progressive course (for more information, see the Chronic inflammatory demyelinating polyradiculoneuropathy article). (medlink.com)
In this article, you will learn about the key differences between CIDP and MS in terms of causes, risk factors, treatment options, and more. (ameripharmaspecialty.com)
CIDP treatment aims to reverse or stop nerve damage. (ameripharmaspecialty.com)
Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a peripheral nervous system disease associated with polyautoimmunity. (turkishjournalpediatrics.org)
Not all chronic inflammatory demyelinating polyneuropathy (CIDP) patients respond to IV immunoglobulin (IVIg) and it is not known why some patients need only one or two courses whilst others need long term treatment. (spin-awards.com)
This will help us to understand why some CIDP patients respond better to IVIg than others and why some require long term treatment. (spin-awards.com)
Parallel to this residency she started her PhD research (The spectrum of GBS, CIDP and its IVIg treatment) under supervision of Prof. P.A. van Doorn. (spin-awards.com)
Wel of niet vaccineren tegen het nieuwe influenza A (H1N1)-virus bij het syndroom van Guillain-Barré en CIDP? (spin-awards.com)
Evidence from randomized trials supports the use of intravenous immunoglobulin in Guillain-Barré syndrome, chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and multifocal motor neuropathy with conduction block (MMNCB). (qxmd.com)
Corticosteroid treatment is beneficial in CIDP, but not in Guillain-Barré syndrome and may worsen MMNCB. (qxmd.com)
GAMUNEX-C is an intravenous immune globulin (IVIG) treatment approved to treat chronic inflammatory demyelinating polyneuropathy (CIDP) in adults. (gamunex-c.com)
Managing your CIDP over the long term is very important to your treatment success. (gamunex-c.com)
Chronic Inflammatory demyelinating Polyradiculoneuropathy (CIDP) is an uncommon autoimmune disorder. (advancells.com)
Although the tests have technical limitations, they are very useful in detecting conditions that may benefit from specialized treatment, such as chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). (newportneurospecialists.com)
Background: Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an immune-mediated condition with variable clinical characteristics and different treatment modalities. (ac.ir)

Mathey EK, Park SB, Hughes RA, Pollard JD, Armati PJ, Barnett MH et al (2015) Chronic inflammatory demyelinating polyradiculoneuropathy: from pathology to phenotype. (springer.com)
Van den Bergh PY, Hadden RD, Bouche P, Cornblath DR, Hahn A, Illa I et al (2010) European Federation of Neurological Societies/Peripheral Nerve Society guideline on management of chronic inflammatory demyelinating polyradiculoneuropathy: report of a joint task force of the European Federation of Neurological Societies and the Peripheral Nerve Society - first revision. (springer.com)
Bunschoten C, Jacobs BC, Van den Bergh PYK, Cornblath DR, van Doorn PA (2019) Progress in diagnosis and treatment of chronic inflammatory demyelinating polyradiculoneuropathy. (springer.com)
It can be considered the chronic equivalent of acute inflammatory demyelinating polyradiculoneuropathy, the most common form of Guillain-Barré syndrome. (medscape.com)
Electron micrograph of the peripheral nerve of a patient with chronic inflammatory demyelinating polyradiculoneuropathy. (medscape.com)
Chronic inflammatory demyelinating polyradiculoneuropathy is presumed to occur because of immunologic antibody-mediated reaction along with interstitial and perivascular infiltration of the endoneurium with inflammatory T cells and macrophages. (medscape.com)
The disorder is sometimes called chronic relapsing polyneuropathy (CRP) or chronic inflammatory demyelinating polyradiculoneuropathy (because it involves the nerve roots). (wikipedia.org)
The inflammatory neuropathies are characterized by a broad spectrum of disorders and include chronic inflammatory demyelinating polyradiculoneuropathy, multifocal motor neuropathy, chronic immune sensory polyradiculopathy, paraproteinemic polyneuropathies, and nodal and paranodal neuropathies. (medlink.com)
Intravenous immunoglobulin response in treatment-naïve chronic inflammatory demyelinating polyradiculoneuropathy. (spin-awards.com)
Randomised controlled trial comparing two different immunoglobulins in chronic inflammatory demyelinating polyradiculoneuropathy. (spin-awards.com)
Guillain-Barre syndrome, also known as acute demyelinating polyradiculoneuropathy or Landry's palsy, is a rare condition characterized by the immune system's attack on a portion of the peripheral nervous system. (doctorworld.net)
Treatment for acute demyelinating polyradiculoneuropathy syndrome primarily aims to prevent complications, alleviate symptoms, and expedite recovery. (doctorworld.net)
The diagnosis of GBS is clinical but may be aided by electrophysiology which is also important to characterise the two main electrophysiological subtypes: acute inflammatory demyelinating polyradiculoneuropathy (AIDP), which is sensory and motor and displays demyelinating changes on nerve conduction studies, and acute motor axonal neuropathy (AMAN), which is primarily axonal and thought to be purely motor. (bmj.com)
Guillain-Barré syndrome has now become recognized as a clinical syndrome that may be due to several pathological entities, consisting of an acute inflammatory demyelinating polyradiculoneuropathy as well as an acute motor axonal neuropathy. (unicamp.br)
The diagnosis is often delayed with intervening incorrect diagnoses of chronic inflammatory demyelinating polyradiculoneuropathy, myeloproliferative disorder, and monoclonal gammopathy of undetermined significance. (wustl.edu)

Allen JA, Merkies ISJ, Lewis RA (2020) Monitoring clinical course and treatment response in chronic inflammatory demyelinating polyneuropathy during routine care: a review of clinical and laboratory assessment measures. (springer.com)
citation needed] Dendrite Soma Axon Nucleus Node of Ranvier Axon terminal Schwann cell Myelin sheath Chronic inflammatory demyelinating polyneuropathy (or polyradiculoneuropathy) is considered an autoimmune disorder destroying myelin, the protective covering of the nerves. (wikipedia.org)

investigated lymphocyte subsets in patients with acute inflammatory demyelinating polyneuropathy (AIDP) and acute motor axonal neuropathy (AMAN) before and after treatment with IVIG to explore the possible mechanism of IVIG action. (medscape.com)
Treatments include corticosteroids, intravenous Ig (IVIg), subcutaneous Ig, and plasma exchange, but not all patients achieve meaningful benefits and factors including safety risks, costs, and burdensome treatment regimens. (medscape.com)
We also review the currently available treatment options, including intravenous immunoglobulin (IVIg), corticosteroids (CCS), and plasma exchange (PE), and discuss how to approach treatment-refractory cases. (aanem.org)
Intravenous immunoglobulin (IVIG) has been used primarily for immune deficiency patients, and its greatest expansion is seen more and more in the treatment of autoimmune disorders, especially in neurology. (nursingcenter.com)
The benefits of IVIG treatment include its availability in all treatment centers and its ease of administration in an outpatient setting. (nursingcenter.com)
Better studies are also needed to provide higher-level quality of evidence regarding the efficacy of IVIG and TPE treatments, according to the authors. (pharmacytimes.com)
In their new study, investigators conducted a systematic literature review of studies comparing the efficacy of TPE versus IVIG to treat autoimmune neurological disorders with the goal of identifying conditions in which both treatments show similar efficacies and those where one may be preferable. (pharmacytimes.com)
One study favored IVIG because of the shorter patient intubation times required for MG treatment. (pharmacytimes.com)
The review included only 1 study comparing TPE and IVIG in encephalitis, which reported longer hospitalization times and lower discharge possibility after treatment with TPE. (pharmacytimes.com)
TPE is widely accepted as a mainstay treatment for NMO relapses, although a few case series have reported the possible benefit of IVIG. (pharmacytimes.com)
The median time to the initial treatment was shortest for patients receiving plasma exchange alone (0.03 months) or in combination with a steroid (0.03 months), followed by IVIG plus another therapy (0.53 months), and then IVIG alone (0.71 months). (ahdbonline.com)
IVIG for Infertility: Is This Treatment Right for You? (ameripharmaspecialty.com)
We aim to investigate genetic factors associated with IVIg response or treatment dependency. (spin-awards.com)
IVIG treatment and prognosis in Guillain-Barré syndrome. (spin-awards.com)

After six months of monthly intravenous immunoglobulin and oral methylprednisolone treatments, the patient was able to dorsiflex his left foot and walk without support. (turkishjournalpediatrics.org)
Treatment of Guillain-Barré syndrome with intravenous immunoglobulin appears to be as effective as plasma exchange in one controlled trial. (unicamp.br)

IV steroid therapy alone is not indicated for the treatment of AIDP. (medscape.com)

In the polyradiculoneuropathy Guillain-Barre as an example of de-and remyelination, the values of the NMRPS remained barely influenced despite a significant reduction in the motor nerve conduction velocity. (david-reitter.com)
Nerve conduction research (NCS) and electromyography (EMG) performed 1?week after neurological starting point showed the lack of the F influx in both reduced limbs with a minor amplitude lower and regular latency in CMAP reactions suggesting a lumbosacral polyradiculoneuropathy. (bibf1120.com)

Experimental models have suggested potential new treatments for human inflammatory neuropathy, but current practice is largely based on empirical trials. (qxmd.com)

Neurology: For patients on general medicine or other services, neurological consultation is indicated to manage diagnostic studies and to help determine appropriate treatment. (medscape.com)

Conventional immunosuppressant treatments with corticosteroids have failed to show benefit. (medscape.com)

Treatment is less likely to be effective if initiated more than 2 weeks after the onset of symptoms. (medscape.com)
Most patients with immune-mediated neuromuscular diseases experience improvement of symptoms and quality-of-life measures with appropriate treatment. (medlink.com)
In cases when nerve function cannot be restored, treatment aims at preventing the symptoms from getting worse. (ameripharmaspecialty.com)
Also called plasma exchange, this treatment removes antibodies (proteins causing your symptoms) from your blood. (ameripharmaspecialty.com)
Early treatment is crucial to improve the chances of limiting symptoms. (ameripharmaspecialty.com)
Without treatment, your symptoms will likely worsen. (ameripharmaspecialty.com)
Which treatment is given depends on how severe the symptoms are, among other things. (medlineplus.gov)
The most aggressive treatment is only given if you have difficulty walking, breathing, or if symptoms don't allow you to care for yourself or work. (medlineplus.gov)

Despite these limitations, early diagnosis and treatment is favoured in preventing irreversible axonal loss and improving functional recovery. (wikipedia.org)
So what was the problem with getting an accurate diagnosis and treatment during those decades? (neuropathyjournal.org)
These patients are expected to stay in the hospital until enough events are captured to assure their physician that the correct diagnosis and treatment plan are in place. (newportneurospecialists.com)

Ultrasonographic and electrophysiological studies were performed on the median and ulnar nerves before treatment in all patients and followed up in 45 patients. (springer.com)
IGIV-C (Gamunex) or placebo was given every 3 weeks for up to 24 weeks in an initial treatment period, and patients who did not show an improvement in INCAT disability score of 1 point or more received the alternate treatment in a crossover period. (nih.gov)
Patients who showed an improvement and completed 24 weeks of treatment were eligible to be randomly re-assigned in a blinded 24-week extension phase. (nih.gov)
These treatments should be administered cautiously under the direction of a cardiologist or critical care specialist, since one of the main causes of death is iatrogenic hypotension, especially in patients with autonomic failure. (medscape.com)
Of those patients, 66% showed evidence of clinical improvement and a rapid onset of effect with the efgartigimod PH20 SC treatment, and 70% of the patients were then entered into stage B, a double-blind randomized phase, with 111 of patients receiving continued efgartigimod PH20 SC weekly and 110 receiving placebo for 48 weeks. (medscape.com)
Two treatments for GBS were shown to be beneficial in large randomized and controlled trials involving more than 700 patients. (nursingcenter.com)
Investigators concluded that treatment choices should be tailored to patients' individual needs and based on available clinical resources. (pharmacytimes.com)
These conflicting results highlight the need for tailored treatment decisions based on patients' needs and individual situations. (pharmacytimes.com)
Further research is needed to understand the rationale for treatment decisions in this patient population and their potential impact on patients and health plans. (ahdbonline.com)
Antibody titres decreased or became negative in patients improving on treatment. (bmj.com)
Treatment withdrawal was associated with a titre increase and clinical deterioration in four patients. (bmj.com)
Biological agents have emerged as effective therapies for patients with treatment-resistant immune-mediated neuromuscular diseases. (medlink.com)
The timely and accurate identification of neurotoxicity helps clinicians detect and treat these complications early, thereby enhancing treatment efficiency and improving the prognosis of patients. (hindawi.com)
Pembrolizumab (Keytruda), a humanized monoclonal anti-PD-1 antibody, is the first anti-PD-1 antibody approved by the FDA for the treatment of patients with unresectable or metastatic melanoma, non-small-cell lung cancer (NSCLC), head and neck squamous cell carcinoma, cervical cancer, colorectal cancer, and gastric/gastroesophageal junction cancer [ 4 - 10 ]. (hindawi.com)
Prompt treatment directed at the underlying plasma cell clone produces dramatic responses in the majority of patients. (wustl.edu)
We assessed patients at baseline, one day after treatment, and at a one-month follow-up.Results: Groups showed no significant difference at baseline. (ac.ir)

There is an unmet need for a first-line treatment with long-term efficacy that maintains or improves quality of life, has an early onset of action, is well tolerated, is not dependent on plasma donation, and has greater convenience," the investigators write in their abstract. (medscape.com)
POEMS syndrome is a paraneoplastic syndrome whose acronym stands for less than half of the defining features of the disease, that is polyradiculoneuropathy, organomegaly, potentially including co-existing Castleman's disease, endocrinopathy, monoclonal plasma cell neoplasm, and skin changes. (wustl.edu)
The diagnosis is based on having both the polyradiculoneuropathy and the monoclonal plasma cell disorder, and at least one of the other 3 major criteria (Castleman's disease, sclerotic bone lesions, or elevated VEGF) and at least one minor criterion. (wustl.edu)

Case report 1 A 58\year\old man with high\quality B lymphoma received treatment with rituximab and cyclophosphamide, and triple intrathecal therapy (MTX, Ara\C, and dexamethasone) as CNS prophylaxis. (bibf1120.com)

Herraets IJT, Goedee HS, Telleman JA, van Eijk RPA, van Asseldonk JT, Visser LH et al (2020) Nerve ultrasound improves detection of treatment-responsive chronic inflammatory neuropathies. (springer.com)
The inflammatory neuropathies affect 1 to 2 individuals per 100,000 population, resulting in major disability and impairment even with treatment. (nursingcenter.com)
Current treatment options are discussed for the most frequent of these diseases: inflammatory neuropathies, myasthenia gravis, and inflammatory myopathies. (medlink.com)
Although they share some clinical and electrophysiological features, the inflammatory neuropathies differ in their presentation, immunopathogenesis, response to treatment, and outcome. (medlink.com)
Treatment of immune-mediated inflammatory neuropathies. (qxmd.com)

Therapeutic apheresis is a complex treatment requiring careful administration to guarantee safety and efficacy. (rwjbh.org)

Their inclusion in this category is due to the presence of inflammation seen on nerve biopsy and their response to immunosuppressant or immunomodulatory treatments. (medlink.com)

Botulism is frequently misdiagnosed, most often as a polyradiculoneuropathy (Guillain-Barré or Miller-Fisher syndrome), myasthenia gravis, or other diseases of the central nervous system. (cdc.gov)

The decrease in CSA after treatment may also indicate better prognosis. (springer.com)

Several specific therapies have emerged as potential treatments for immune-mediated neuromuscular diseases. (medlink.com)

Some people can get their normal nerve function back with treatment. (ameripharmaspecialty.com)

1997. Severe sensorimotor polyradiculoneuropathy after ingestion of ethylene glycol. (cdc.gov)

Delmont E, Brodovitch A, Kouton L, Allou T, Beltran S, Brisset M et al (2020) Antibodies against the node of Ranvier: a real-life evaluation of incidence, clinical features and response to treatment based on a prospective analysis of 1500 sera. (springer.com)

Finally, we emphasize the need to adopt objective outcome measures to monitor treatment response. (aanem.org)

BACKGROUND: Early diagnosis of hereditary ATTR polyneuropathy (ATTRv-PN) is important since treatment options have become available, which are most effective early in the disease course. (bvsalud.org)

Clinical improvement was determined using the modified Rankin scale, need for alternative and/or additional treatments and assessment of the treating neurologist. (bmj.com)

Descriptions of the disease course, clinical heterogeneity, treatment regimes, variations in laboratory values, and antibody titers will help reach consensus on diagnosis and follow-up strategies. (bvsalud.org)

1 Individual heterogeneity in disease severity and disability, as well as treatment response, affect the choice of initial and long-term therapy. (ahdbonline.com)

Biomarkers are needed to predict response or duration of treatment to give more individualized treatment. (spin-awards.com)

Given individual variations in health, it is crucial to consult a healthcare provider to determine the most appropriate diagnosis, treatment, and management plan. (doctorworld.net)

1999. American Academy of Clinical Toxicology practice guidelines on the treatment of ethylene glycol poisoning. (cdc.gov)
1999. Fomepizole in treatment of uncomplicated ethylene glycol poisoning. (cdc.gov)

The authors concluded that future studies on autoimmune neurological disorders should be prospective and quality-of-life assessments should be included in order to evaluate the long-term benefit of different treatments. (pharmacytimes.com)

See Treatment and Medication for more detail. (medscape.com)

1988. Treatment of ethylene glycol poisoning with intravenous 4-methylpyrazole. (cdc.gov)

Treatment for wound botulism may also include wound debridement to remove the source of toxin‑producing bacteria and antibiotic therapy. (cdc.gov)

Biofeedback - This treatment teaches the patient to become aware of body processes, such as heart rate, temperature regulation, and muscle tension. (ppschicago.com)
The patient underwent complete en-bloc resection of the chest wall, including the ribs, muscle, and parietal pleura. (biomedcentral.com)

In other cases, nerves are badly damaged and cannot heal, so treatment is aimed at preventing the disease from getting worse. (medlineplus.gov)

It is self-limited, and a theoretical concern is treatment of pain with prostaglandin synthetase inhibitors, which could prevent ovulation. (passmed.uk)

Diseases5

Chemicals and Drugs1

Analytical, Diagnostic and Therapeutic Techniques and Equipment2

Phenomena and Processes2

Health Care1

CIDP44

Demyelinating Polyradiculoneuropathy15

Chronic inflammatory d2

IVIG14

Intravenous immunoglobulin2

AIDP1

Conduction2

Neuropathy1

Neurology1

Corticosteroids1

Symptoms8

Diagnosis and treatment3

Patients16

Plasma3

Cyclophosphamide1

Neuropathies5

Efficacy1

Immunosuppressant1

Myasthenia gravis1

Prognosis1

Immune-mediated1

Nerve1

Severe1

Clinical features1

Outcome1

Polyneuropathy1

Assessment1

Antibody1

Heterogeneity1

Duration of treatment1

Management1

19992

Disorders1

Medication1

Poisoning with intravenous1

Include1

Patient2

Worse1

Inhibitors1