From the Research
Treatment options for Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) should prioritize first-line therapies such as intravenous immunoglobulin (IVIG), corticosteroids, and plasma exchange, with the most recent evidence suggesting that these treatments have similar efficacy and safety profiles 1.
First-Line Treatment Options
- IVIG is typically administered at 2g/kg divided over 2-5 days initially, followed by maintenance doses of 1g/kg every 3-4 weeks, adjusted based on response.
- Corticosteroids like prednisone are often started at 60-100mg daily and gradually tapered to the lowest effective dose, with studies showing no significant difference in efficacy between different corticosteroid regimens 2.
- Plasma exchange may involve 4-5 exchanges over 1-2 weeks.
Second-Line Treatment Options
- For patients who don't respond adequately to first-line treatments, second-line options include immunosuppressants such as azathioprine (2-3mg/kg/day), mycophenolate mofetil (1-2g/day), cyclosporine (3-5mg/kg/day), or rituximab (375mg/m² weekly for 4 weeks) 3.
- Treatment is typically long-term, with attempts to reduce dosage after stabilization.
Adjunctive Therapies
- Physical and occupational therapy are important adjuncts to medication, helping to manage residual symptoms and improve quality of life 4.
- Treatment choice depends on individual factors including disease severity, comorbidities, and patient preference.
Disease Management
- CIDP is an autoimmune disorder where the immune system attacks the myelin sheath of peripheral nerves, and these treatments work by suppressing or modulating the immune response to prevent further nerve damage and allow for repair 5.
- Early diagnosis and treatment are crucial to prevent irreversible axonal loss and optimize improvement in function.