Chronic inflammatory demyelinating polyradiculoneuropathy - an overview of existing treatment options and prospects for the future

Abstract

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an immune-mediated polyneuropathy. CIDP can cause prolonged periods of disability with many patients becoming severely debilitated at some time during their illness. Several open, uncontrolled studies and blinded, randomised clinical trials have shown thatimmunomodulatory therapyhas a beneficial effect in CIDP. This paper reviews existing treatment options, provides a treatment algorithm and discusses prospects for the future. Corticosteroids, intravenous immunoglobulin, plasma exchange, immunosuppressive agents such as azathioprine, methotrexate, mycophenolate mofetil, cyclophosphamide, cyclosporine A, rituximab, alemtuzumab, etanercept, tacrolimus, interferon beta and alpha and autologous stem cell transplantation have been used in CIDP. Only corticosteroids, intravenous immunoglobulin and plasmapheresis have been proven to be effective in randomised controlled trials, however. As non-responsiveness to treatment seems to beassociated with a greaterdegree of axonal dysfunction, finding therapies aimed at protecting the axon and restoring axonal damage are needed. © Touch Briefings 2011.