IVIg versus methylprednisone in CIDP: The treatment dilemmas!

The long-term treatment of CIDP is a vexing one often mired in lack of data from randomized controlled trials.  The ICE study suggested that a maintenance IVIg dose of 1g/kg every 3 weeks is associated with good therapeutic outcome.  Subsequent studies have suggested that steroids may lead to remission in a greater proportion of patients, although the side-effects may be limiting.  The question remains about the longevity of therapy and at what point therapies in CIDP can be stopped.  In an upcoming issue of JNNP, Nobile-Orazio report on outcomes in CIDP patients in whom IVIg and steroid therapy were stopped.  Interestingly, while a similar proportion of patients tended to relapse in both treatment groups (IVIg vs steroids) the time to relapse was longer in the steroid group, supporting previous studies.  The question of harmful effects of steroids, however, remains!

 

Read more http://jnnp.bmj.com/content/early/2014/09/22/jnnp-2013-307515.abstract

 

J Neurol Neurosurg Psychiatry doi:10.1136/jnnp-2013-307515
  • Neuromuscular
  • Research paper

Frequency and time to relapse after discontinuing 6-month therapy with IVIg or pulsed methylprednisolone in CIDP