What are the treatment options for CIDP?

Chronic inflammatory demyelinating polyneuropathy (CIDP) is a neuromuscular disorder that causes damage to the peripheral nerves (the nerves outside the brain and spinal cord).

More specifically, CIDP causes inflammation and damage to the myelin sheath, a layer of proteins and fatty substances that covers, insulates, and protects nerve fibers. The myelin sheath also acts as a conductor for nerve impulses. This allows signals to travel along the nervous system quickly.

CIDP can affect anyone at any age, but it most often occurs in young males.

Symptoms of CIDP

CIDP impairs the functioning of the nervous system. When myelin is damaged, nerve signals will not be able to travel through the nervous system at their normal speed, and some nerve signals may become blocked. This can cause muscle weakness, abnormal sensations, and a loss of coordination and motor function.

Some common symptoms of CIDP:

• Muscle weakness and loss of muscle definition and size
• Tingling, numbness, prickling, burning, pain, or other unusual sensations
• Loss of feeling (for example, being unable to feel a pin prick)
• Problems with balance and coordination, leading to clumsiness and difficulty walking
• Problems with fine motor skills
• Difficulty with speech and swallowing
• Fatigue

Symptoms are typically symmetrical, affecting the same muscle groups and limbs on both sides of the body. But symptoms can vary from person to person, and there are different subtypes of CIDP—for instance, a person can experience problems with balance without loss of muscle strength or sensory symptoms.

Treatment for CIDP

The cause of CIDP is unknown, but it is believed to be an autoimmune disease—a disorder where the immune system attacks healthy tissues. Several therapies that help regulate the immune system are mainstays of treatment for CIDP and are often effective. These include:

• Intravenous immunoglobulin (IVIg). Infusions of immunoglobulins (antibodies) help regulate the immune system and reduce inflammation. It is not fully understood how immunoglobulin therapy works to treat CIDP, but this therapy has been proven to be effective. Most people require ongoing infusions, though the schedule of those infusions can vary from person to person.
• Subcutaneous immunoglobulin (SCIg). Immunoglobulin can also be delivered with a subcutaneous infusion (into a fatty layer under the skin instead of into a vein). Subcutaneous infusions can be given at home, either self-administered or administered with the help of a caregiver. Subcutaneous immunoglobulin can be used as maintenance therapy for CIDP once a person has had induction therapy with intravenous immunoglobulin.
• Plasma exchange. Also known as plasmapheresis, this procedure involves removing a portion of the patient's blood plasma to remove potentially harmful antibodies and immune cells. This is accomplished by circulating blood through a special machine. Plasma is discarded and replaced with donated plasma. This helps regulate the immune system.
• Corticosteroids. Corticosteroid drugs reduce inflammation and help suppress the immune system and can be useful in getting CIDP into remission. “Pulse corticosteroids” refers to a dosing schedule where a person is given high-dose infusions of a corticosteroid drug on specific days over the course of several months.
• Immunosuppressant drugs. Drugs that suppress the immune system may be prescribed when other treatments haven’t been effective.

Supportive therapies can also help improve a person’s quality of life while living with CIDP. This can include working with a physical therapist, occupational therapist, and a provider that specializes in mental health.

A treatment plan should be built around a person’s individual symptoms and needs. A healthcare provider will always be your best source of information about your diagnosis and your treatment options, and the many factors that need to be considered when choosing a treatment.