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Plasma exchange for chronic inflammatory demyelinating polyradiculoneuropathy
M M Mehndiratta1, R A C Hughes, P Agarwal
1Neurology, G.B.Pant Hospital, Professor, Department of Neurology, D-II, Kidwai Nagar-west, New Delhi, India, 110023.
The Cochrane Database of Systematic Reviews
|July 22, 2004
Summary
Plasma exchange offers short-term benefits for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) patients, improving disability and nerve function. However, rapid deterioration can occur post-treatment, necessitating further research for sustained efficacy.
Area of Science:
- Neurology
- Immunology
- Clinical Trials
Background:
- Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a rare, progressive, or relapsing paralytic disease affecting peripheral nerves.
- Autoimmunity is hypothesized as a cause, suggesting autoantibody removal via plasma exchange may be therapeutic.
Purpose of the Study:
- To evaluate the efficacy and safety of plasma exchange (PE) for treating CIDP.
Main Methods:
- Systematic review of randomized or quasi-randomized controlled trials comparing PE with sham or no treatment.
- Data extracted and quality assessed independently by two authors; meta-analysis performed where possible.
Main Results:
- One crossover trial (18 participants) showed significant improvement in disability after PE compared to sham exchange.
- Combined results from two trials (47 participants) demonstrated significant improvements in impairment and electrophysiological measures with PE.
- Adverse events occurred in 3-17% of procedures, some serious.
Conclusions:
- Plasma exchange provides significant short-term benefits for approximately two-thirds of CIDP patients.
- Rapid deterioration can occur after PE, and adverse events are not uncommon.
- Further research is needed to identify strategies for prolonging the therapeutic effects of plasma exchange.