From the Research
Yes, there is a clear link between Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) and autoimmune diseases, as CIDP itself is considered an autoimmune disorder where the immune system mistakenly attacks the myelin sheath covering peripheral nerves. Patients with CIDP have a higher likelihood of developing other autoimmune conditions such as thyroid disorders, rheumatoid arthritis, systemic lupus erythematosus, and inflammatory bowel disease. This association exists because individuals with one autoimmune disease often have genetic predispositions and immune dysregulation that increase their risk for developing additional autoimmune conditions. The shared pathophysiology involves abnormal immune responses where T-cells and antibodies target the body's own tissues. For CIDP patients, this means regular screening for other autoimmune conditions may be beneficial, especially if new symptoms develop.
Key Points
- CIDP is an autoimmune disease characterized by progressive peripheral neuropathy, with symptoms including weakness, paresthesias, and sensory dysfunction 1.
- The etiology of CIDP is multifactorial, with both genetic and environmental factors contributing to it, and possible antigenic self-targets include myelin protein 0, myelin protein 2, and peripheral myelin protein 22 1.
- Treatment approaches for CIDP often overlap with those for other autoimmune conditions, with immunosuppressive and immunomodulatory therapies like corticosteroids, intravenous immunoglobulin (IVIG), plasma exchange, and medications such as rituximab or azathioprine being effective for both CIDP and other autoimmune conditions 2.
- Recent studies have shown that mycophenolate mofetil (MMF) may be a well-tolerated and potentially effective adjunctive medication in CIDP patients with suboptimal response to first-line therapies, with improvements in outcome measures and meaningful cost reductions 3.
Treatment Considerations
- First-line therapies for CIDP include corticosteroids, intravenous or subcutaneous immunoglobulin, or plasma exchange, as suggested by the recently revised EAN/PNS guidelines for the management of CIDP 2.
- Second-line options, such as immunosuppressants or rituximab, may be used in special cases, and novel therapeutic approaches, including molecules or monoclonal antibodies interacting with Fc receptors on immune cells, are currently undergoing clinical studies 2.
- MMF has been shown to facilitate improvement in outcome measures in treatment-resistant CIDP, with a reduction in median IVIg dose and DCU utilization, and cost savings averaging £38,432 per patient/year 3.