Treatment of CIDP

Pract Neurol. 2023 Feb;23(1):46-53. doi: 10.1136/pn-2021-002991. Epub 2022 Sep 15.

Abstract

Chronic inflammatory demyelinating polyneuropathy is a disabling but treatable disorder. However, misdiagnosis is common, and it can be difficult to optimise its treatment. Various agents are used both for first and second line. First-line options are intravenous immunoglobulin, corticosteroids and plasma exchange. Second-line therapies may be introduced as steroid-sparing agents or as more potent escalation therapy. It is also important to consider symptomatic treatment of neuropathic pain and non-pharmacological interventions. We discuss the evidence for the various treatments and explain the practicalities of the different approaches. We also outline strategies for monitoring response and assessing the ongoing need for therapy.

Keywords: neuropathy.

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Diagnostic Errors
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use
  • Plasma Exchange
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating* / diagnosis
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating* / drug therapy

Substances

  • Immunoglobulins, Intravenous
  • Adrenal Cortex Hormones