Immunosuppressive treatment in refractory chronic inflammatory demyelinating polyradiculoneuropathy. A nationwide retrospective analysis

D. Cocito, S. Grimaldi, I. Paolasso, Y. Falcone, G. Antonini, L. Benedetti, C. Briani, R. Fazio, S. Jann, S. Matà, M. Sabatelli, E. Nobile-Orazio

Research output: Contribution to journalArticle

Abstract

Background and purpose: There are other options open to patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) who are non-responders to conventional treatment, including immunosuppressive and immunomodulatory agents (IA). The aim of this study was to assess whether the use of IA is able to increase the number of responders. Methods: Clinical and electrophysiological data of patients with refractory CIDP, followed at 10 Italian centres, were collected, and the clinical outcome (Rankin Scale) and drug side effects (SE) for the different therapies were analysed. Results: A total of 110 patients were included. These patients underwent 158 different therapeutic procedures with IA. Seventy-seven patients were treated with azathioprine, 18 rituximab, 13 cyclophosphamide, 12 mycophenolate mofetil, 12 cyclosporine, 12 methotrexate, 11 interferon-alpha and three interferon beta-1a. The percentage of patients who responded to azathioprine (27%) was comparable to the percentage of responders to other therapies, after the exclusion of interferon beta-1a that was not effective in any of the three patients treated. The percentage of SE ranges from 8% (methotrexate) to 50% (cyclosporine). Conclusions: One-fourth of patients, refractory to conventional treatment, showed an improvement in their disability with IA. Methotrexate had the lowest SE; cyclosporine was associated with severe SE and often led to drug discontinuation.

Original languageEnglish
Pages (from-to)1417-1421
Number of pages5
JournalEuropean Journal of Neurology
Volume18
Issue number12
DOIs
Publication statusPublished - Dec 2011

Keywords

  • Chronic inflammatory demyelinating polyneuropathy
  • Chronic inflammatory demyelinating polyradiculoneuropathy
  • Immunosuppressant drugs
  • Therapy

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

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