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Treatment of CIDP
  1. Janev Fehmi1,
  2. Roberto Bellanti2,
  3. Siraj A Misbah3,
  4. Anupam Bhattacharjee4,
  5. Simon Rinaldi1
  1. 1Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
  2. 2Neurology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
  3. 3Clinical Immunology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
  4. 4Neurology, Royal Free Hampstead NHS Trust, London, UK
  1. Correspondence to Dr Simon Rinaldi, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford OX1 2JD, UK; simon.rinaldi{at}ndcn.ox.ac.uk

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.

  • neuropathy

Data availability statement

All data relevant to the study are included in the article.

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Data availability statement

All data relevant to the study are included in the article.

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Footnotes

  • Contributors JF and SR wrote the original draft of the manuscript. RB contributed to subsequent drafts and revisions. AB specifically wrote the section relating to plasma exchange. SAM provided expertise regarding Immunoglobulin and in particular subcutaneous administration. All authors approved the final version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed by Rob Hadden, London, UK, and Michael Lunn, London, UK.

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