Intravenous immunoglobulin treatment in patients with chronic inflammatory demyelinating polyneuropathy.

Intravenous immunoglobulin (IVIg) treatment is shown to be effective in a selected group of patients with a chronic inflammatory demyelinating polyneuropathy (CIDP). The proportion of patients that improve after IVIg treatment varies between studies. Because 40% of a group of IVIg treated CIDP patients needed intermittent IVIg infusions to maintain their improved clinical condition, it is expected that IVIg is effective, at least in this subgroup of patients. However, the proportion of patients that improve after IVIg is highly dependent on the selection of patients. Patients with signs and symptoms of an active disease and clear involvement of both arms and legs appear to have the highest chance of improvement after IVIg treatment, but additional or prospective studies are needed to verify these criteria. Results obtained from small numbers of patients treated in open studies suggest that CIDP patients with a monoclonal gammopathy may also improve after IVIg treatment. Further studies are required to evaluate the prognostic factors for improvement after IVIg treatment in CIDP patients and to compare the efficacy and safety of IVIg with other long-term treatment regimes. New studies should also focus on the mechanism of IVIg treatment in patients with CIDP.