Immunoglobulins in chronic inflammatory demyelinating polyneuropathy

This article reviews the efficacy and tolerability of intravenous immunoglobulins (IVIg) in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), including those forms associated with monoclonal gammopathy (paraproteinemic demyelinating neuropathy, PDN). Class I trials demonstrated that IVIg are effective in CIDP. About two-thirds of patients respond to initial treatment; however, most of them require repeated drug doses to maintain improvement. For PDN there are some evidences that IVIg are efficacious; however, it seems that less than 50% of the patients respond to this treatment and the persistence of the response over time has not been thoroughly investigated. The safety profile of immunoglobulins is generally good; however, the possibility of the occurrence of serious adverse effects should always be considered before starting treatment.