From the Research
The best treatment for Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) is intravenous immunoglobulin (IVIG) or corticosteroids, with plasma exchange as an alternative, as these treatments have been shown to be effective in reducing inflammation and preventing immune cells from attacking the myelin sheath around nerves, allowing for nerve repair and improved signal transmission, as supported by the most recent study 1. The treatment of CIDP typically involves immunotherapy to suppress the abnormal immune response.
- First-line treatments include:
- Intravenous immunoglobulin (IVIG) at a loading dose of 2g/kg over 2-5 days, followed by maintenance doses of 1g/kg every 3-4 weeks, adjusted based on response.
- Corticosteroids, such as prednisone starting at 60-100mg daily, then gradually tapered.
- Plasma exchange (5 exchanges over 2 weeks) may be used as an alternative. For patients who don't respond to these treatments, immunosuppressants like azathioprine (2-3mg/kg/day), mycophenolate mofetil (1-2g/day), or rituximab (375mg/m² weekly for 4 weeks) can be considered, as discussed in 2 and 3. Treatment is typically long-term and requires regular monitoring for side effects and clinical response, with the goal of preventing disability and maintaining quality of life, as emphasized in 4 and 5. Physical therapy is also important to maintain strength and function, and should be individualized based on disease severity, comorbidities, and patient preferences. Key considerations in treatment include:
- Reducing inflammation and preventing immune cells from attacking the myelin sheath around nerves.
- Allowing for nerve repair and improved signal transmission.
- Individualizing treatment based on disease severity, comorbidities, and patient preferences.
- Regular monitoring for side effects and clinical response.
- The use of immunosuppressants as second-line therapy for patients who do not respond to first-line treatments.