Epidemiology, presentation, management and outcomes in chronic inflammatory demyelinating polyneuropathy in Birmingham, UK: the impact of ethnicity
Rajabally, Zeinab Spencer, Lydia Mistry, Niraj Rajabally, Yusuf A
Rajabally, Zeinab
Spencer, Lydia
Mistry, Niraj
Rajabally, Yusuf A
Affiliation
University Hospitals Birmingham NHS Foundation Trust; Aston University
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Publication date
2025-09-29
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Abstract
Background: Whether ethnicity impacts on epidemiology, presentation, management, and outcome is unknown in chronic inflammatory demyelinating polyneuropathy (CIDP).
Methods: We studied the prevalence/incidence of CIDP in Asian (Indian/Pakistani/Bangladeshi) and white subjects in Birmingham, UK, and associations of ethnicity with demographics/deprivation/phenotype/treatment and outcomes.
Results: On 10th July 2025, CIDP prevalence was 6.18 per 100 000 (95% CI: 4.66-8.05). Prevalence was lower in Asian (Indian/Pakistani/Bangladeshi) compared to white subjects (2.64 per 100 000 vs. 10.15 per 100 000; RR: 0.260, 95% CI: 0.111-0.609; p < 0.001). Prevalence in ≥ 50-year-olds was lower in Asian (Indian/Pakistani/Bangladeshi) compared to white subjects (8.00 per 100 000 vs. 46.68 per 100 000; RR: 0.172; 95% CI: 0.061-0.479; p < 0.001) but similar in 18-49-year-olds (2.48 per 100 000 vs. 1.83 per 100 000; RR: 1.355, 95% CI: 0.273-6.712; p = 0.661). Mean incidence of CIDP was 0.54 per 100 000 per year (95% CI: 0.404-0.713). CIDP incidence was lower in Asian (Indian/Pakistani/Bangladeshi) than in white subjects (0.24 per 100 000 per year vs. 0.86 per 100 000 per year, RR: 0.278; 95% CI: 0.118-0.654; p = 0.002). Asian (Indian/Pakistani/Bangladeshi) ethnicity was independently associated with younger age (p = 0.037), greater social deprivation (p = 0.045), and noncompliance to treatment (p = 0.016). No association of Asian (Indian/Pakistani/Bangladeshi) ethnicity was found with CIDP sub-type, diagnostic delay, pretreatment disability, access to high-cost therapies, or posttreatment outcomes.
Conclusions: Subjects of Asian (Indian/Pakistani/Bangladeshi) ethnicity in the UK may have a lower risk of CIDP after 50 years of age, but an equivalent risk between 18 and 49 years, compared to white subjects. They may present younger, be more socially deprived, and be more likely noncompliant to treatment, compared to white subjects.
Citation
Rajabally Z, Spencer L, Mistry N, Rajabally YA. Epidemiology, Presentation, Management and Outcomes in Chronic Inflammatory Demyelinating Polyneuropathy in Birmingham, UK: The Impact of Ethnicity. J Peripher Nerv Syst. 2025 Dec;30(4):e70065. doi: 10.1111/jns.70065.
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Article