title: Long-term remission of CIDP after pulsed dexamethasone or short-term prednisolone treatment.
abstract: OBJECTIVE
  Achieving long-term remission after a limited more intense treatment period would prevent prolonged use of corticosteroids or IV immunoglobulin (IVIg) in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). In this prospective cohort study we present long-term follow-up data on patients included in a multicenter randomized controlled trial comparing 6 monthly pulses of dexamethasone with 8 months of daily prednisolone.
  
  
  METHODS
  Treatment effect was assessed with the Inflammatory Neuropathy Cause and Treatment disability scale and the Rivermead Mobility Index and was categorized using the CIDP Disease Activity Status (CDAS) scale.
  
  
  RESULTS
  By March 2011, 39 out of 40 patients were included with a median follow-up of 4.5 years. Cure (>5 years off treatment) or remission according to the CDAS criteria after 1 or 2 courses of pulsed dexamethasone or daily prednisolone was achieved in 10 out of 39 patients (26%). Half of the patients who were in remission after initial treatment experienced a relapse (median treatment-free interval: 17.5 months for dexamethasone, 11 months for prednisolone). Alternative diagnosis was made in 7 out of 12 (58%) who did not respond to any therapy and in none of the treatment-responsive patients.
  
  
  CONCLUSIONS
  Cure or long-term remission can be achieved in about one-quarter of patients with CIDP after 1 or 2 courses of pulsed dexamethasone or 8-month daily prednisolone. In treatment-nonresponsive patients, the diagnosis CIDP should be reconsidered.
  
  
  METHODS
  This study provides Class IV evidence that pulsed dexamethasone or 8-month daily prednisolone can lead to long-term remission in CIDP.
authors.affiliation: Department of Neurology, Academic Medical Center, Amsterdam, the Netherlands. f.eftimov@amc.uva.nl
authors.forename: F
authors.initials: F
authors.lastname: Eftimov
authors.forename: M
authors.initials: M
authors.lastname: Vermeulen
authors.forename: P A
authors.initials: PA
authors.lastname: van Doorn
authors.forename: E
authors.initials: E
authors.lastname: Brusse
authors.forename: I N
authors.initials: IN
authors.lastname: van Schaik
mesh_terms: D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D015331:Cohort Studies; D003907:Dexamethasone / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006801:Humans; D020277:Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / Q000188:drug therapy* / Q000473:pathology*; D011239:Prednisolone / Q000008:administration & dosage*; D011446:Prospective Studies; D020551:Pulse Therapy, Drug; D012074:Remission Induction; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D003907:Dexamethasone; D011239:Prednisolone