PMID- 30027593
OWN - NLM
STAT- MEDLINE
DCOM- 20191022
LR  - 20191022
IS  - 1529-8027 (Electronic)
IS  - 1085-9489 (Linking)
VI  - 23
IP  - 3
DP  - 2018 Sep
TI  - Conventional and unconventional therapies in typical and atypical chronic 
      inflammatory demyelinating polyneuropathy with different clinical course of 
      progression.
PG  - 183-189
LID - 10.1111/jns.12282 [doi]
AB  - Intravenous immunoglobulin (IVIG), corticosteroids and therapeutic plasma 
      exchange (TPE) are evidence-based conventional treatments for chronic 
      inflammatory demyelinating polyneuropathy (CIDP). In many centres, unconventional 
      treatments are frequently used as alternatives. We evaluated the outcome of 
      conventional and unconventional therapies in 31 CIDP patients. Overall response 
      rate with conventional first-line immunotherapies was 77% (20/26), comparable 
      between IVIG and corticosteroids (80% vs 70%). Use of TPE was limited. Treatment 
      response among typical and atypical CIDP were comparable (76 vs 80%). 
      Non-responders were patients with progressive form of typical CIDP and DADS. 
      Majority (21/26, 81%) of patients with persistent neurological deficits received 
      maintenance therapy. Two subgroups of patients frequently treated with 
      maintenance immunosuppressants were those with improving or stable disease 
      following first-line treatment (12, 57%) and those with progressive form of CIDP 
      (2, 10%). Primary indications for immunosuppressant use were 
      corticosteroids-sparing and additional immunosuppression effects. Nine (64%) 
      patients with improving or stable disease given azathioprine were taken off 
      corticosteroids after a median duration of 14 months (range 12-108). Two (14%) 
      eventually achieved cure or clinical remission without treatment. Maintenance 
      IVIg was given to 6 (29%) relapsing CIDP patients; none of achieved cure or 
      remission after similar median duration of treatment. Less potent 
      immunosuppressant drugs (azathioprine, mycophenolate mofetil, and methotrexate) 
      were frequently used, with moderate adverse effect profiles. In resource limited 
      setting, unconventional treatments were commonly used among CIDP patients with 
      different clinical course of progression. In most cases, careful risk-benefit 
      re-assessment is required to justify its further use.
CI  - (c) 2018 Peripheral Nerve Society.
FAU - Hung, Stefanie K Y
AU  - Hung SKY
AD  - Department of Neurology, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia.
FAU - Hiew, Fu L
AU  - Hiew FL
AD  - Department of Neurology, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia.
FAU - Viswanathan, Shanthi
AU  - Viswanathan S
AD  - Department of Neurology, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia.
FAU - Puvanarajah, Santhi
AU  - Puvanarajah S
AD  - Department of Neurology, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia.
LA  - eng
PT  - Journal Article
DEP - 20180814
PL  - United States
TA  - J Peripher Nerv Syst
JT  - Journal of the peripheral nervous system : JPNS
JID - 9704532
RN  - 0 (Adrenal Cortex Hormones)
RN  - 0 (Immunoglobulins, Intravenous)
RN  - 0 (Immunosuppressive Agents)
SB  - IM
MH  - Adrenal Cortex Hormones/*therapeutic use
MH  - Adult
MH  - Aged
MH  - Female
MH  - Humans
MH  - Immunoglobulins, Intravenous/*therapeutic use
MH  - Immunosuppressive Agents/*therapeutic use
MH  - Immunotherapy/*methods
MH  - Male
MH  - Middle Aged
MH  - Plasma Exchange/methods
MH  - Polyradiculoneuropathy, Chronic Inflammatory Demyelinating/*therapy
MH  - Retrospective Studies
MH  - Treatment Outcome
OTO - NOTNLM
OT  - chronic inflammatory demyelinating polyneuropathy
OT  - conventional treatment
OT  - corticosteroids
OT  - intravenous immunoglobulin
OT  - plasma exchange
OT  - unconventional treatment
EDAT- 2018/07/22 06:00
MHDA- 2019/10/23 06:00
CRDT- 2018/07/21 06:00
PHST- 2018/05/08 00:00 [received]
PHST- 2018/07/14 00:00 [revised]
PHST- 2018/07/16 00:00 [accepted]
PHST- 2018/07/22 06:00 [pubmed]
PHST- 2019/10/23 06:00 [medline]
PHST- 2018/07/21 06:00 [entrez]
AID - 10.1111/jns.12282 [doi]
PST - ppublish
SO  - J Peripher Nerv Syst. 2018 Sep;23(3):183-189. doi: 10.1111/jns.12282. Epub 2018 
      Aug 14.