Maintenance IV immunoglobulin treatment in chronic inflammatory demyelinating polyradiculoneuropathy

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Abstract

CIDP patients treated with intravenous immunoglobulin (IVIg) usually start with a standard dosage of 2 g/kg body weight. Only a minority of patients have a sustained improvement, and most require ongoing maintenance treatment. Preferred IVIg regimens however vary considerably between doctors and at present it is unknown which is optimal. Since there are also large differences in IVIg dosage and interval requirements between patients, optimal IVIg maintenance treatment of CIDP is even more complex. The lack of evidence based guidelines on how IVIg maintenance treatment should be administered may potentially lead to under- or overtreatment of this expensive therapy. We provide an overview of published practical IVIg maintenance treatment regimens, IVIg maintenance schedules used in randomized controlled trials and one based upon our own long-term experience on how this treatment could be given in CIDP.

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