There are many treatment options available for CIDP

The European Academy of Neurology and Peripheral Nerve Society guidelines on the diagnosis and treatment of CIDP are the standard that most healthcare professionals use to determine the treatment options that are best for their patients. Below are the recommended treatments listed according to the guidelines.

CIDP treatment options

According to the clinical treatment guidelines, the recommendations for initial treatment of CIDP include:

IVIG1,2

IVIG, or intravenous immune globulin, is a therapy for CIDP. IVIG is comprised of proteins that come from donated human plasma. It provides antibodies to block the immune and inflammatory processes that attack and destroy myelin. The way in which IVIG works in the treatment of patients with CIDP is not completely understood.

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Corticosteroids3,4

Corticosteroids imitate the effects of hormones that are produced by the body to suppress the immune system and reduce inflammation. They work by exceeding the body’s natural levels of steroids to help suppress the immune system. However, how corticosteroids work in treatment of patients with CIDP is not completely understood.

Plasmapheresis5

Plasmapheresis, or plasma exchange, is a procedure that removes proteins from the blood—including proteins that cause disease, and then returns white blood cells—red blood cells, and platelets back into the body.

Recommendations for maintenance treatment after initial treatment include continuing IVIG and corticosteroids, as well as:

SCIG

SCIG, or subcutaneous immune globulin, is IG therapy that is given under the skin. It is approved as a maintenance therapy for CIDP after a patient has been stable on IVIG.

Immunosuppressants (various drugs that regulate your immune system)1,6

Immunosuppressants help weaken the body's immune system. They alter the function of immune cells which may help prevent the immune system from attacking body tissues. While their effectiveness is debated, doctors may consider them if corticosteroids, IVIG, or plasmapheresis are not appropriate or can't be used. However, how immunosuppressants work in treatment of patients with CIDP is not completely understood.

Other treatment options not currently in the guidelines include:

FcRn inhibitors7

The neonatal Fc receptor (FcRn) is a protein that binds to immunoglobulin G (IgG), preventing it from breaking down. This means that some harmful IgG can build up. Treatments that target FcRn receptors keep them from binding IgG and reduce the amount in your body.

Supportive treatments8

Your doctor may send you to a physical therapist to help you recondition your muscles to improve muscle strength, function, and mobility, or to an occupational therapist to help you learn new ways of doing everyday tasks despite physical limitations.

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References:

  1. Koski CL. CIDP: Chronic Inflammatory Demyelinating Polyneuropathy. Narberth, PA: GBS/CIDP Foundation International; 2012.
  2. Chronic inflammatory demyelinating polyneuropathy. National Institutes of Health website. https://medlineplus.gov/ency/article/000777.htm. Accessed January 28, 2025.
  3. Corticosteroid (oral route, parenteral route). Mayo Clinic website. http://www.mayoclinic.org/drugs-supplements/corticosteroid-oral-route-parenteral-route/description/drg-20070491?p=1. Accessed January 28, 2025.
  4. Steroids. NHS Choices website. https://www.nhs.uk/conditions/steroid-injections/. Accessed January 28, 2025.
  5. Plasmapheresis. National Multiple Sclerosis Society website. http://www.nationalmssociety.org/Treating-MS/Managing-Relapses/Plasmapheresis. Accessed January 28, 2025.
  6. Treating lupus with immunosuppressive medications. Johns Hopkins Medicine website. https://www.hopkinslupus.org/lupus-treatment/lupus-medications/immunosuppressive-medications/. Accessed January 28, 2025.
  7. Rajabally YA. Chronic inflammatory demyelinating polyradiculoneuropathy: current therapeutic approaches and future outlooks. ImmunoTargets and Therapy. 2024;13:99-110.
  8. Chronic inflammatory demyelinating polyradiculoneuropathy. University of Rochester Medical Center website. https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=134&ContentID=210. Accessed January 28, 2025.