CIDP is a progressive disease; as previously noted, undiagnosed and untreated cases result in permanent and devastating disability. On the basis of studies demonstrating their efficacy in improving motor and sensory function, corticosteroids, IVIg/SCIg, and PE are the standard first-line treatments for CIDP.
Several IVIg and SCIg therapies have been approved by the US Food and Drug Administration to treat acquired immunodeficiencies. Infusion therapies indicated for the treatment of CIDP include IVIg and corticosteroid drugs and one SCIg drug. These therapies have been shown to improve motor function in a large percentage of study participants.
In a process that is similar to dialysis, plasma exchange involves the removal of whole blood from a patient to filter out plasma antibodies, cytokines, and complements responsible for peripheral nerve myelin damage. The plasma is then replaced with albumin and returned to the patient along with red and white blood cells, platelets, and saline.
In cases wherein first-line therapies do not provide adequate improvement or are discontinued owing to adverse effects, second-line therapies to consider include long-term use of immunosuppressant and immunomodulatory drugs (eg, azathioprine, cyclosporine, cyclophosphamide) and supportive medications (gabapentin, carbamazepine, tricyclic antidepressants).
Nerve stimulation, high-dose anti-inflammatory drugs, beta-blockers, anticoagulation, and antibiotic therapies are not indicated for or effective in treating CIDP.
For more on immunomodulatory/immunosuppressive agents to treat CIDP, read here.
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Cite this: Jafar Kafaie. Fast Five Quiz: How Much Do You Know About Chronic Inflammatory Demyelinating Polyradiculoneuropathy? - Medscape - Feb 08, 2019.