Therapeutic options for chronic inflammatory demyelinating polyradiculoneuropathy: a systematic review

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a rare acquired immunemediated progressive or relapsing disorder causing peripheral neuropathic disease of durations more than two months. Many individuals with CIDP fail to make a long-term recovery with current treatment regimes. The aim of this study was to systematically review the current literature to determine the best treatment option for CIDP using data published on recent randomised controlled trials. Papers published from January 1990 to June 2012 were searched for studies on therapies to treat adults with CIDP. In this systematic review, nine placebo-controlled double-blind randomised trials were reviewed to treat subjects with CIDP. Two randomised controlled trials for treating CIDP using intravenous immunoglobulin (IVIg) versus placebo and another trial of rituximab showed significant short-term benefit for treating CIDP. IVIg therapy remains the current first line treatment for CIDP. Rituximab also showed promising results and was well tolerated, however large studies are needed toTherapies using monoclonal antibodies directed against the cells components or proteins offer the most promise for treatment of CIDP however they also need further research, as does the use of stem cell therapy for treating CIDP. 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.