IVIG Discontinued Much Less Frequently than Methylprednisolone for CIDP

Intravenous immunoglobulin (IVIG) therapy was less frequently discontinued due to inefficacy, adverse events or intolerance than intravenous methylprednisolone for the treatment of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), according to a multicenter, randomized, double-blind, placebo-controlled, parallel-group study in 45 patients conducted at Milan University

A dose of 0.5 g/kg of IVIG or 0.5 g of methylprednisolone was administered daily for four consecutive days on a monthly basis for six months. The primary study outcome was the difference in the number of patients discontinuing either therapy owing to inefficacy or intolerance. Secondary endpoints included the difference in the proportion of patients experiencing adverse events or worsening after therapy discontinuation.

Eleven of 21 (52%) patients stopped methylprednisolone therapy during the study period, while only three of 24 (13%) patients treated with IVIG stopped therapy, translating into a relative risk of 0.54 (95% CI, 0.34 to 0.87; p=0.0085). The proportion of patients experiencing adverse events did not differ between the methylprednisolone and IVIG groups. Following discontinuation of therapy, however, more patients on IVIG therapy worsened and required further therapy (8 of 21; 38%) than did those on methylprednisolone (0 of 10; p=0.0317).