Intravenous immunoglobulin for chronic inflammatory demyelinating polyradiculoneuropathy: a systematic review.
This review discusses the efficacy and safety in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) of intravenous immunoglobulin and compares this treatment with plasma exchange and prednisolone. We searched publications from 1985 onwards for randomised controlled studies examining the effects of intravenous immunoglobulin in patients with this immune-mediated neuromuscular disorder. Six trials, with 170 patients in total, were judged eligible. A significantly higher proportion of patients improved in disability within a month after the start of treatment with intravenous immunoglobulin than with placebo (relative risk 3.17 [95% CI 1.74 to 5.75]). During this period, intravenous immunoglobulin has similar efficacy to plasma exchange and oral prednisolone; therefore which of these treatments should be the first choice is currently uncertain. An algorithm on treatment approaches for CIDP is proposed.
van Schaik
Ivo N
IN
Department of Neurology, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands. i.n.vanschaik@amc.uva.nl
Winer
John B
JB
de Haan
Rob
R
Vermeulen
Marinus
M
D000465:Algorithms; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000009:adverse effects / Q000627:therapeutic use*; D010951:Plasma Exchange; D020277:Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / Q000188:drug therapy* / Q000503:physiopathology; D011239:Prednisolone / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic
D000893:Anti-Inflammatory Agents; D016756:Immunoglobulins, Intravenous; D011239:Prednisolone