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
- Neuromuscular
- Research paper
Frequency and time to relapse after discontinuing 6-month therapy with IVIg or pulsed methylprednisolone in CIDP
- Eduardo Nobile-Orazio1,
- Dario Cocito2,
- Stefano Jann3,
- Antonino Uncini4,
- Paolo Messina5,
- Giovanni Antonini6,
- Raffaella Fazio7,
- Francesca Gallia1,
- Angelo Schenone8,
- Ada Francia9,
- Davide Pareyson10,
- Lucio Santoro11,
- Stefano Tamburin12,
- Guido Cavaletti13,
- Fabio Giannini14,
- Mario Sabatelli15,
- Ettore Beghi5
- for the IMC Trial Group