From the Research
Chronic inflammatory demyelinating polyneuropathy (CIDP) treatment should prioritize first-line therapies such as intravenous immunoglobulin (IVIG), plasma exchange, or corticosteroids, with the goal of reducing nerve inflammation and damage, as supported by the most recent study 1.
Treatment Options
- First-line treatments:
- Intravenous immunoglobulin (IVIG) at 2g/kg over 2-5 days initially, followed by maintenance doses of 1g/kg every 3-4 weeks
- Plasma exchange (5 exchanges over 2 weeks)
- Corticosteroids like prednisone (starting at 60mg daily with gradual taper)
- Second-line options for non-responders:
- Immunossuppressants such as azathioprine (2-3mg/kg/day), mycophenolate mofetil (2g/day), cyclosporine (3-5mg/kg/day), or rituximab (375mg/m² weekly for 4 weeks)
Prognosis and Quality of Life
- The prognosis for CIDP varies widely, with about 60-80% of patients responding well to treatment, achieving remission or significant improvement 2
- Early diagnosis and treatment are essential for better outcomes, as they help prevent permanent nerve damage
- Regular neurological assessments are needed to monitor disease activity and adjust treatment accordingly
- Physical therapy is crucial to maintain strength and function, improving quality of life for patients with CIDP
Recent Evidence
- A recent study 1 highlights the importance of considering both induction and maintenance therapies for CIDP, with plasma exchange and intravenous immunoglobulin therapy being effective as induction treatments, and corticosteroid administration being effective for both induction and maintenance.
- Another study 3 emphasizes the need for optimizing treatment plans, considering the potential for misdiagnosis and the importance of symptomatic treatment of neuropathic pain and non-pharmacological interventions.