Natalizumab as a Disease-Modifying Therapy in Chronic Inflammatory Demyelinating Polyneuropathy - A Report of Three Cases.
BACKGROUND
Several treatments are available to treat the immune-mediated chronic inflammatory demyelinating polyneuropathy (CIDP). Among these treatments, intravenous immunoglobulins, corticosteroids and plasma exchanges are validated and widely used. A few immunosuppressive drugs have been tried, but they had little efficiency.


METHODS
We describe three CIDP patients treated by Natalizumab (acting against cellular adhesion and T-cell migration) after a failure of the validated treatments.


RESULTS
We observed a long-term improvement in one patient, a dramatic improvement over a significant duration in another patient and stabilization in the last one.


CONCLUSIONS
This open label study provides evidence for the value of Natalizumab as second-line treatment for individual patients with a high dependency on waning efficacy of first-line therapies. CIDP is characterized by heterogeneity of clinical phenotypes, electrophysiological and pathological features, and various variable courses types of evolution. The different responses to drugs of our patients are consistent with some reported cases and may reflect the spectrum of lesional mechanisms and the molecular dysfunctions in CIDP.
Department of Neurology, National Referral Center for 'Rare Peripheral Neuropathies', University Hospital Limoges, Limoges, France.
Jean-Michel
JM
Vallat
Stéphane
S
Mathis
Karima
K
Ghorab
Michel-André
MA
Milor
Laurence
L
Richard
Laurent
L
Magy
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D000069442:Natalizumab / Q000627:therapeutic use*; D020277:Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology
D007155:Immunologic Factors; D000069442:Natalizumab