CIDPUSA Foundation
Intractable chronic inflammatory demyelinating polyneuropathy
treated successfully with ciclosporin.
J Neurol Neurosurg Psychiatry. 2005 Aug;76(8):1115-20.
Odaka M, Tatsumoto M, Susuki K, Hirata K, Yuki N.
Department of Neurology, Dokkyo University School of Medicine,
BACKGROUND: Chronic inflammatory demyelinating polyneuropathy (CIDP)
is a heterogeneous disorder and both clinical course and response to treatment vary widely. Because of the propensity for relapse, CIDP requires maintenance therapy after the initial response to treatment. There is no consensus regarding this in the published
literature.Present report: A patient with CIDP was treated with oral prednisolone and cyclophosphamide pulse therapy but required repeated plasma exchange and intravenous immunoglobulin (IVIg).
Treatment with ciclosporin freed the patient from repeated IVIg administration. Therapeutic responses in 14 subsequent cases including three patients who showed improvement with ciclosporin are
also presented along with an algorithm of the authors' suggested protocol for treatment. CONCLUSION: Ciclosporin should be considered for patients with intractable CIDP who require repeated IVIg.
J Neurol
Neurosurg Psychiatry. 2006 Apr;77(4):544-7.
Treatment of chronic inflammatory demyelinating polyradiculoneuropathy with methotrexate.
Hughes RA.
Department of Molecular
Neuroscience, Institute of Neurology, Queen Square, London WC1N 3BG, UK. doreen@doctors.org.uk.
We discovered many reports of other immunosuppressive drugs being used in adults with
chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) but none of methotrexate. As weekly low dose oral methotrexate is safe, effective, and well tolerated in other diseases,
we treated 10 patients with otherwise treatment resistant CIDP. Seven showed improvement in strength by at least two points on the MRC sum score and three worsened. Only two showed an
improvement in disability and both were also receiving corticosteroids. We discuss the difficulty of detecting an improvement in treatment resistant CIDP and propose methotrexate as
a suitable agent for testing in a randomized trial.
PMID: 16543541 [PubMed - in process]
2002 Jun 25;58(12):1856-8.
High-dose cyclophosphamide without stem-cell rescue
for refractory CIDP.
Brannagan TH 3rd, Pradhan A, Heiman-Patterson T, Winkelman AC, Styler MJ, Topolsky DL, Crilley PA, Schwartzman RJ, Brodsky I, Gladstone DE.
Department of Neurology,
MCP-Hahnemann University, Philadelphia, PA, USA.
Four patients with chronic inflammatory demyelinating polyneuropathy (CIDP) who were refractory to conventional treatment were
treated with high-dose cyclophosphamide (200 mg/kg over 4 days). All improved in functional status and muscle strength. Nerve conduction studies improved in three of four. Other immunomodulatory
medications have been discontinued. High-dose cyclophosphamide can be given safely to patients with CIDP and patients with disease persistence after standard therapy may have a response that
lasts for over 3 years and results in long-term disease remission.
PMID: 12084892 [PubMed - indexed for
MEDLINE]
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