Long‐term Immunoglobulin therapy for chronic inflammatory demyelinating polyradiculoneuropathy
- 30 December 2014
- journal article
- issues and-opinions
- Published by Wiley in Muscle & Nerve
- Vol. 51 (5), 657-661
- https://doi.org/10.1002/mus.24554
Abstract
Immunoglobulins are an effective but expensive treatment for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Although the goal is to improve function, use of functional scales to monitor therapy is not widespread. Limited recent evidence suggests that doses lower than those used traditionally may be as effective. There are no proven correlations of effective dose with weight, disease severity, or duration. The clinical course of CIDP is heterogeneous and includes monophasic forms and complete remissions. Careful monitoring of immunoglobulin use is necessary to avoid overtreatment. Definitive evidence for immunoglobulin superiority over steroids is lacking. Although latest trial evidence favors immunoglobulins over steroids, the latter may result in higher remission rates and longer remission periods. This article addresses the appropriateness of first-line, high-dose immunoglobulin treatment for CIDP and reviews important clinical questions regarding the need for long-term therapy protocols, adequate monitoring, treatment withdrawal, and consideration of corticosteroids as an alternative to immunoglobulin therapy. Muscle Nerve 51:657–661, 2015Keywords
This publication has 39 references indexed in Scilit:
- Modifying the Medical Research Council grading system through Rasch analysesBrain, 2011
- Thromboembolic complications of intravenous immunoglobulin therapy in patients with neuropathy: A two-year studyJournal of the Neurological Sciences, 2011
- Understanding the consequences of chronic inflammatory demyelinating polyradiculoneuropathy from impairments to activity and participation restrictions and reduced quality of life: the ICE studyJournal of the Peripheral Nervous System, 2010
- Cost-utility of Intravenous Immunoglobulin (IVIG) compared with corticosteroids for the treatment of Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) in CanadaCost Effectiveness and Resource Allocation, 2010
- Incidence and prevalence of CIDP and the association of diabetes mellitusNeurology, 2009
- Acute motor response following a single IVIG treatment course in chronic inflammatory demyelinating polyneuropathyMuscle & Nerve, 2009
- Epidemiologic variability of chronic inflammatory demyelinating polyneuropathy with different diagnostic criteria: Study of a UK populationMuscle & Nerve, 2009
- Muscle performance relates to physical function and quality of life in long‐term chronic inflammatory demyelinating polyradiculoneuropathyJournal of the Peripheral Nervous System, 2008
- Randomized controlled trial of intravenous immunoglobulin versus oral prednisolone in chronic inflammatory demyelinating polyradiculoneuropathyAnnals of Neurology, 2001
- A plasma exchange versus immune globulin infusion trial in chronic inflammatory demyelinating polyradiculoneuropathyAnnals of Neurology, 1994