Current treatments of chronic immune-mediated demyelinating polyneuropathies.

Muscle Nerve. 2009 May;39(5):563-78.

Brannagan TH 3rd.

Peripheral Neuropathy Center, Neurological Institute, Columbia University College of Physicians and Surgeons, 710 West 168th Street, Box 163, New York, New York 10032, USA.

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), multifocal motor neuropathy (MMN), and anti-myelin-associated glycoprotein (anti-MAG) neuropathy are three demyelinating acquired neuropathies, with distinct responses to immunotherapy. In placebo-controlled, double-blind, randomized trials, intravenous immunoglobulin (IVIg) has been effective for CIDP and MMN, and plasmapheresis has been effective for CIDP. Corticosteroids have been beneficial in controlled trials for CIDP. Other agents, including cyclophosphamide, rituximab, azathioprine, cyclosporine, interferons, fludarabine, mycophenolate mofetil, and etanercept, have been reported to benefit some patients with inflammatory demyelinating neuropathies in case series and case reports. This review examines the use and toxicity associated with these immunotherapy medications in treating patients with chronic immune-mediated demyelinating neuropathies. Muscle Nerve, 2009.