Rituxan for CDIP – pro
Peripheral neuropathy may be either inherited or acquired through disease processes or trauma. In many cases, however, a specific cause cannot be identified. Doctors usually refer to neuropathies with no known cause as idiopathic. Usual treatment follows establishing the underlying cause and treats this cause. Chronic inflammatory demyelinating polyneuropathy (CIDP) is the most common acquired autoimmune demyelinating neuropathy. Patients respond to steroids, plasmapheresis and IVIg but require frequent infusions of IVIg (at least once or twice per 6 weeks) or a high-dose steroid regimen to maintain the response. A number of patients, up to 40% in one series, do not respond well to these therapies and remain with significant disability. There is a need for an effective immunosuppressant in CIDP, either as add-on therapy for the poor responders or as a steroid or IVIg-sparing agent. The experience with rituximab up to now, although limited to case reports, appears encouraging, but on the level of case reports.
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