Unconventional treatments for chronic inflammatory demyelinating polyneuropathy

Research output: Contribution to journalReview article

Abstract

This article focuses on the unconventional treatments used in chronic inflammatory demyelinating polyneuropathy (CIDP). First line, evidence-based treatments for CIDP include corticosteroids, immunoglobulins and plasma exchanges. Several unproven treatments are however given in treatment-refractory disease or to reduce requirements in validated therapies for reasons of side effects/practical delivery/cost. Despite methodological issues, IFN-α, azathioprine and methotrexate have not been shown to be useful in randomized controlled trials. Cyclophosphamide, rituximab and, as final resort in highly selected cases, hematopoietic stem cell transplant may be options considered in severely disabled refractory patients. Debatably, azathioprine, methotrexate, cyclosporine and mycophenolate mofetil are still occasionally used, among others, in milder disease. Physical therapy may be of benefit in CIDP but is not systematically considered as an integral part of management strategies. Current literature relating to unconventional therapies in CIDP is reviewed here and the possible avenues that require consideration in severe refractory disease and less disabling forms are discussed.

Original languageEnglish
Pages (from-to)331-342
Number of pages12
JournalNeurodegenerative disease management
Volume7
Issue number5
DOIs
Publication statusPublished - 18 Oct 2017

Fingerprint

Chronic Inflammatory Demyelinating Polyradiculoneuropathy
Azathioprine
Methotrexate
Therapeutics
Mycophenolic Acid
Plasma Exchange
Hematopoietic Stem Cells
Cyclophosphamide
Cyclosporine
Immunoglobulins
Adrenal Cortex Hormones
Randomized Controlled Trials
Transplants
Costs and Cost Analysis

Keywords

  • autologous hematopoietic stem cell transplant
  • chronic inflammatory demyelinating polyneuropathy
  • cyclophosphamide
  • immunosuppressant
  • physical therapy
  • refractory
  • rituximab
  • treatment
  • unconventional

Cite this

Rajabally, Yusuf A. / Unconventional treatments for chronic inflammatory demyelinating polyneuropathy. In: Neurodegenerative disease management. 2017 ; Vol. 7, No. 5. pp. 331-342.
@article{b400c3e7a1e04012adbb6668118bd9b0,
title = "Unconventional treatments for chronic inflammatory demyelinating polyneuropathy",
abstract = "This article focuses on the unconventional treatments used in chronic inflammatory demyelinating polyneuropathy (CIDP). First line, evidence-based treatments for CIDP include corticosteroids, immunoglobulins and plasma exchanges. Several unproven treatments are however given in treatment-refractory disease or to reduce requirements in validated therapies for reasons of side effects/practical delivery/cost. Despite methodological issues, IFN-α, azathioprine and methotrexate have not been shown to be useful in randomized controlled trials. Cyclophosphamide, rituximab and, as final resort in highly selected cases, hematopoietic stem cell transplant may be options considered in severely disabled refractory patients. Debatably, azathioprine, methotrexate, cyclosporine and mycophenolate mofetil are still occasionally used, among others, in milder disease. Physical therapy may be of benefit in CIDP but is not systematically considered as an integral part of management strategies. Current literature relating to unconventional therapies in CIDP is reviewed here and the possible avenues that require consideration in severe refractory disease and less disabling forms are discussed.",
keywords = "autologous hematopoietic stem cell transplant, chronic inflammatory demyelinating polyneuropathy, cyclophosphamide, immunosuppressant, physical therapy, refractory, rituximab, treatment, unconventional",
author = "Rajabally, {Yusuf A.}",
year = "2017",
month = "10",
day = "18",
doi = "10.2217/nmt-2017-0017",
language = "English",
volume = "7",
pages = "331--342",
number = "5",

}

Unconventional treatments for chronic inflammatory demyelinating polyneuropathy. / Rajabally, Yusuf A.

In: Neurodegenerative disease management, Vol. 7, No. 5, 18.10.2017, p. 331-342.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Unconventional treatments for chronic inflammatory demyelinating polyneuropathy

AU - Rajabally, Yusuf A.

PY - 2017/10/18

Y1 - 2017/10/18

N2 - This article focuses on the unconventional treatments used in chronic inflammatory demyelinating polyneuropathy (CIDP). First line, evidence-based treatments for CIDP include corticosteroids, immunoglobulins and plasma exchanges. Several unproven treatments are however given in treatment-refractory disease or to reduce requirements in validated therapies for reasons of side effects/practical delivery/cost. Despite methodological issues, IFN-α, azathioprine and methotrexate have not been shown to be useful in randomized controlled trials. Cyclophosphamide, rituximab and, as final resort in highly selected cases, hematopoietic stem cell transplant may be options considered in severely disabled refractory patients. Debatably, azathioprine, methotrexate, cyclosporine and mycophenolate mofetil are still occasionally used, among others, in milder disease. Physical therapy may be of benefit in CIDP but is not systematically considered as an integral part of management strategies. Current literature relating to unconventional therapies in CIDP is reviewed here and the possible avenues that require consideration in severe refractory disease and less disabling forms are discussed.

AB - This article focuses on the unconventional treatments used in chronic inflammatory demyelinating polyneuropathy (CIDP). First line, evidence-based treatments for CIDP include corticosteroids, immunoglobulins and plasma exchanges. Several unproven treatments are however given in treatment-refractory disease or to reduce requirements in validated therapies for reasons of side effects/practical delivery/cost. Despite methodological issues, IFN-α, azathioprine and methotrexate have not been shown to be useful in randomized controlled trials. Cyclophosphamide, rituximab and, as final resort in highly selected cases, hematopoietic stem cell transplant may be options considered in severely disabled refractory patients. Debatably, azathioprine, methotrexate, cyclosporine and mycophenolate mofetil are still occasionally used, among others, in milder disease. Physical therapy may be of benefit in CIDP but is not systematically considered as an integral part of management strategies. Current literature relating to unconventional therapies in CIDP is reviewed here and the possible avenues that require consideration in severe refractory disease and less disabling forms are discussed.

KW - autologous hematopoietic stem cell transplant

KW - chronic inflammatory demyelinating polyneuropathy

KW - cyclophosphamide

KW - immunosuppressant

KW - physical therapy

KW - refractory

KW - rituximab

KW - treatment

KW - unconventional

UR - http://www.scopus.com/inward/record.url?scp=85049117505&partnerID=8YFLogxK

UR - https://www.futuremedicine.com/doi/10.2217/nmt-2017-0017

U2 - 10.2217/nmt-2017-0017

DO - 10.2217/nmt-2017-0017

M3 - Review article

C2 - 29043889

AN - SCOPUS:85049117505

VL - 7

SP - 331

EP - 342

IS - 5

ER -