Ask the Experts - What Is the Consensus on Using IVIG to Treat CIDP?
Ask the Experts - What Is the Consensus on Using IVIG to Treat CIDP?
What is the consensus on the use of intravenous immunoglobulin (IVIG) in the treatment of chronic inflammatory demyelinating polyneuropathy (CIDP)? What is the recommended dosage?
CIDP is an autoimmune disorder with a chronic progressive or chronic relapsing course. The illness usually lasts for months to years and leads to variable but often severe chronic disability. I am not aware of any consensus statements on the treatment of CIDP.
Immunotherapies such as IVIG, plasmapheresis, and prednisone are beneficial. IVIG and plasmapheresis seem to be equally effective. Plasmapheresis is more difficult to administer and is associated with more adverse effects. IVIG is effective in 70% to 90% of cases; however, most patients with initial improvement need long-term periodic doses of IVIG to maintain clinical stability.
IVIG is usually given initially at a dose of 0.4 g/kg per day for 5 days. The response is assessed after 1 to 2 months. In patients who continue to worsen or develop periodic relapses, IVIG pulses should be given at 1 g/kg or less as a single infusion in monthly or bimonthly intervals. A weekly dosing schedule may also be useful for maintenance therapy in select cases. The combination of IVIG and prednisone seems to be preferable for long-term management.
What is the consensus on the use of intravenous immunoglobulin (IVIG) in the treatment of chronic inflammatory demyelinating polyneuropathy (CIDP)? What is the recommended dosage?
CIDP is an autoimmune disorder with a chronic progressive or chronic relapsing course. The illness usually lasts for months to years and leads to variable but often severe chronic disability. I am not aware of any consensus statements on the treatment of CIDP.
Immunotherapies such as IVIG, plasmapheresis, and prednisone are beneficial. IVIG and plasmapheresis seem to be equally effective. Plasmapheresis is more difficult to administer and is associated with more adverse effects. IVIG is effective in 70% to 90% of cases; however, most patients with initial improvement need long-term periodic doses of IVIG to maintain clinical stability.
IVIG is usually given initially at a dose of 0.4 g/kg per day for 5 days. The response is assessed after 1 to 2 months. In patients who continue to worsen or develop periodic relapses, IVIG pulses should be given at 1 g/kg or less as a single infusion in monthly or bimonthly intervals. A weekly dosing schedule may also be useful for maintenance therapy in select cases. The combination of IVIG and prednisone seems to be preferable for long-term management.
