title: Therapeutic options for chronic inflammatory demyelinating polyradiculoneuropathy: a systematic review.
abstract: BACKGROUND
  Chronic inflammatory demyelinating polyradiculoneuropathy is a rare acquired immune-mediated progressive or relapsing disorder causing peripheral neuropathic disease of duration more than two months. Many individuals with chronic inflammatory demyelinating polyradiculoneuropathy fail to make a long-term recovery with current treatment regimes. The aim of this study was to prospectively review the literature to determine the effectiveness of therapies for chronic inflammatory demyelinating polyradiculoneuropathy.
  
  
  METHODS
  Articles published from January 1990 to December 2012 were searched for studies to treat adults with chronic inflammatory demyelinating polyradiculoneuropathy. Peer-reviewed full-text articles published in English were included.
  
  
  RESULTS
  Nine placebo-controlled double-blinded randomised trials were reviewed to treat subjects with chronic inflammatory demyelinating polyradiculoneuropathy exhibiting various degrees of effectiveness. The most effect treatments were; three randomised controlled trials using intravenous immunoglobulin, a study comparing pulsed dexamethasone and short term prednisolone and rituximab all showed promising results and were well tolerated.
  
  
  CONCLUSIONS
  IVIg and corticosteroids remain first line treatments for CIDP. Therapies using monoclonal antibodies, such as Rituximab and Natalizumab offer the most promise for treatment of Chronic inflammatory demyelinating polyradiculoneuropathy however they also need further research, as does the use of stem cell therapy for treating Chronic inflammatory demyelinating polyradiculoneuropathy. Large randomised controlled trials and better patient selection are required to address responsiveness of CIDP patients to conventional treatments to elucidate mechanisms of action and future directions for therapeutic improvement.
authors: Faculty of Health Sciences, School of Dentistry, University of Adelaide, Adelaide, Australia. richard.bright@adelaide.edu.au.
authors: Richard J
authors: RJ
authors: Bright
authors: Jenny
authors: J
authors: Wilkinson
authors: Brendon J
authors: BJ
authors: Coventry
mesh_terms: D000305:Adrenal Cortex Hormones / Q000276:immunology / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000276:immunology / Q000627:therapeutic use; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000276:immunology / Q000627:therapeutic use; D007155:Immunologic Factors / Q000276:immunology / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000276:immunology / Q000627:therapeutic use; D000069442:Natalizumab; D020277:Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology*; D016032:Randomized Controlled Trials as Topic / Q000379:methods
chemical_list: D000305:Adrenal Cortex Hormones; D061067:Antibodies, Monoclonal, Humanized; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors; D007166:Immunosuppressive Agents; D000069442:Natalizumab