Corticosteroids for chronic inflammatory demyelinating polyradiculoneuropathy.
BACKGROUND
Chronic inflammatory demyelinating polyradiculoneuropathy is an autoimmune peripheral neuropathy and would be expected to benefit from corticosteroids. Non-randomised studies suggest that corticosteroids are often beneficial.


OBJECTIVE
To evaluate the efficacy of corticosteroids for treating chronic inflammatory demyelinating polyradiculoneuropathy.


METHODS
Search of the Cochrane Neuromuscular Disease Group register for randomised trials of corticosteroids treatment for chronic inflammatory demyelinating polyradiculoneuropathy and enquiry from subject experts.


METHODS
Types of studies: All randomised or quasi-randomised trials Types of participants: All patients with chronic inflammatory demyelinating polyradiculoneuropathy who were diagnosed by an internationally accepted definition. Types of interventions: Treatment with any form of corticosteroid or adrenocorticotropic hormone. Types of outcome measures:


METHODS
Change in disability 12 weeks after randomisation.


METHODS
1. Change in impairment 12 weeks after randomisation. 2. Change in maximum motor nerve conduction velocity or compound muscle action potential amplitude after 12 weeks. 3. Side effects of corticosteroids.


METHODS
One author extracted the data and the other checked them.


RESULTS
We identified one randomised controlled trial, an open study in which 19 corticosteroid treated patients showed more improvement in impairment than 16 untreated controls after 12 weeks. Experience from large non-randomised studies suggests that steroids are beneficial.


CONCLUSIONS
A single randomised controlled trial with 35 participants provided weak evidence to support the common opinion derived from non-randomised studies that oral corticosteroids reduce impairment in chronic inflammatory demyelinating polyradiculoneuropathy. Corticosteroids are known to have serious long term side effects. The long term risks and benefits have not been adequately studied.
Mehndiratta
M M
MM
Neurology, G.B.Pant Hospital, New Delhi, D-II / 103, Kidwai Nagar-West, New Delhi-110023, New Delhi, India, 110023. mmehndi@ndf.vsnl.net.in
Hughes
R A
RA
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D006801:Humans; D020277:Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / Q000188:drug therapy*; D011241:Prednisone / Q000627:therapeutic use
D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D011241:Prednisone