Chronic inflammatory demyelinating polyneuropathy (CIDP) is not just a complicated medical term; it is a rare disease that can cause sensory loss and severely impact mobility.
Although there is currently no known cure, early diagnosis and treatment of CIPD disease can help manage symptoms and prevent irreversible nerve damage.
In this guide, we will explore the various CIDP treatment options available to help you enjoy a higher quality of life with this debilitating disease.
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Speak to a SpecialistUnderstanding CIDP
CIDP is a neurological autoimmune disorder that occurs when the body’s immune system mistakenly attacks the myelin, the protective sheath surrounding peripheral nerves.
This attack disrupts the communication between the nerves and the brain, leading to symptoms that can significantly impact mobility and daily life. Symptoms of CIDP may include:
- Loss of sensation
- Reduced reflexes
- Pain or discomfort
- Weakness in the limbs
- Numbness and tingling
- Difficulty walking or standing
Early recognition of these signs is vital for managing symptoms with appropriate CIDP treatments and preserving nerve function. Without timely treatment of the disease, CIDP can lead to more severe complications such as paralysis.
Difficulty in Diagnosing CIDP
CIDP is extremely rare, with approximately five to seven out of every 100,000 people diagnosed with the disease.
CIDP is often confused with Guillain-Barre syndrome (GBS) because of the similarity of symptoms. Both are autoimmune diseases that affect the myelin (an insulating layer or sheath that forms around nerves).
However, a significant difference is that GBS symptoms progress rapidly and can reach the most severe state in less than 4 weeks without appropriate treatments, while CIDP symptoms take longer to manifest.
Testing for CIDP
Since CIDP is a chronic disease, it is not diagnosed until symptoms persist and worsen over 8 weeks or longer.
To diagnose the disease and recommend the most suitable treatment for CIDP, doctors will review your medical history and may conduct the following tests:
- Blood tests: These tests measure levels of specific markers in your blood to identify inflammation or rule out other conditions that may mimic CIDP.
- Nerve biopsy: A small sample of nerve tissue is taken to examine for damage to the myelin sheath.
- Lumbar puncture (spinal tap): Doctors extract cerebrospinal fluid to look for elevated protein levels and CIDP-associated inflammatory markers.
- Magnetic Resonance Imaging (MRI): MRI scans provide detailed images of the spine and brain, helping doctors identify any abnormalities in the nervous system.
- Nerve conduction studies and electromyography: These tests evaluate the electrical activity in nerves and muscles to assess the damage and the severity of the disease.
Early diagnosis and treatment of CIDP disease can prevent nerve damage and are crucial for successful recovery.
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CIDP Treatment Options
Since CIDP is an autoimmune disease, the prescribed treatments often work to suppress the immune response that is causing the attack on the myelin.
Here is a look at different CIDP treatments available to patients.
Corticosteroids
Corticosteroids are a class of anti-inflammatory medications widely used to manage autoimmune conditions like CIDP. A typical regimen involves oral prednisone or prednisolone. These drugs suppress the immune system and reduce the inflammatory response that damages the myelin.
Corticosteroid treatments for CIDP disease can lead to substantial improvements in muscle strength and reduced symptoms of weakness and sensory loss. A study involving 125 patients found that 60% of participants responded positively to corticosteroids and 61% maintained remission during a 55-month follow-up.
These findings indicate that corticosteroids are reliable first-line treatments for CIDP. In the long term, they can help maintain functional mobility and prevent further degeneration of nerve function.
Intravenous Immune Globulin (IVIG)
Intravenous Immune Globulin (IVIG) involves the infusion of antibodies derived from healthy donors into the bloodstream of individuals with CIDP disease. This treatment works by modulating the immune system and reducing inflammation.
Clinical trials indicate that around 90% of patients benefit from IVIG therapy, showing notable improvements in disability scores and muscle strength. Furthermore, 87% of patients remained relapse-free for an additional 24 weeks, demonstrating the long-term advantages of this treatment.
In addition to alleviating symptoms, IVIG improves patients’ overall quality of life. Many have reported significant improvements in physical functioning and social engagement. These findings highlight the potential of IVIG as a viable treatment option for CIDP.
Plasmapheresis
Plasmapheresis, or plasma exchange, is another treatment for CIDP disease. It involves removing the plasma containing harmful antibodies from blood circulation. This process aims to reduce the autoimmune attacks on the nervous system.
Clinical benefits of plasmapheresis treatments for CIDP include significant short-term improvements in disability and nerve conduction velocities. Studies have shown that approximately 66% of patients experience notable improvements in symptoms following treatment.
In a trial involving 36 participants, those who underwent plasmapheresis demonstrated a mean improvement of 31 points on the Neuropathy Impairment Score after 4 weeks. This result indicates that plasmapheresis can effectively alleviate symptoms and improve overall function.
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About Copay AssistanceSubcutaneous Immunoglobulin (SCIG)
Subcutaneous Immunoglobulin (SCIG) treatment for CIDP disease is administered by injecting immunoglobulin into the fatty tissue beneath the skin.
This method allows for the gradual absorption of antibodies into the bloodstream. It also provides a continuous supply of antibodies to help modulate the immune response. Recent studies have shown that SCIG is as effective as IVIG while having fewer systemic side effects.
A comprehensive meta-analysis of over 1,400 CIDP patients revealed that SCIG significantly improved muscle strength and sensory function while reducing relapse rates. Only 14% of patients experienced a relapse.
These findings highlight the role of SCIG as one of the valuable treatment options for CIDP.
Autologous Hematopoietic Stem Cell Transplantation (HSCT)
Autologous hematopoietic stem cell transplantation (HSCT) is another treatment for CIDP disease. It involves collecting a patient’s stem cells and reintroducing them after high-dose immunosuppressive therapy.
This procedure aims to reset the immune system and halt the autoimmune processes contributing to CIDP. HSCT is typically considered for patients with severe CIDP who have not responded to other treatments.
80% of patients undergoing HSCT achieve long-term remission. Studies indicate significant improvements in muscle strength, quality of life, and nerve conduction velocities post-transplant. These findings suggest that HSCT can be a transformative option for patients with treatment-resistant CIDP.
Monoclonal Antibodies
Monoclonal antibodies like Rituximab (Rituxan) are sometimes used in patients who do not respond to first-line treatments for CIDP disease. These targeted therapies bind to the proteins on the surface of B cells, which play a crucial role in autoimmune responses seen in CIDP.
By destroying B cells, they reduce the production of harmful antibodies that attack the myelin sheath surrounding nerves. This targeted approach can help mitigate the immune system’s attack on the peripheral nerves.
Reviews show that around 75% of those who received Rituximab experienced notable improvements in their symptoms, including enhanced strength and reduced disability scores. These patients previously had limited responses to standard treatment options for CIDP.
Physical Therapy
Doctors may also recommend physical therapy treatment for CIDP patients to alleviate the functional symptoms of the disease.
Physical therapists employ various techniques, including strength training, balance exercises, and gait training, to help patients regain lost motor functions and improve balance and coordination. The goal is to enable patients to maintain independence in daily activities.
Studies show that after a 12-week physical therapy program, 80% of CIDP patients demonstrated significant improvements in their functional abilities. Many noted an enhanced ability to perform activities of daily living, such as walking and climbing stairs, without assistance.
These findings underscore the importance of incorporating physical therapy into the comprehensive treatment plan for CIDP.
New CIDP Treatments
In 2024, the FDA approved three new drugs for the treatment of CIDP disease. These drugs are:
- HYQVIA (used for maintenance therapy): HYQVIA is a subcutaneous infusion that combines immune globulin with recombinant human hyaluronidase. This formulation helps enhance absorption, making it easier for patients to receive treatment at home.
- GAMMAGARD LIQUID: GAMMAGARD LIQUID is a 10% immunoglobulin solution derived from human plasma. It replenishes antibodies in individuals with primary immunodeficiency and offers an effective treatment option for CIDP.
- Vyvgart Hytrulo (used by adults): Vyvgart Hytrulo is a subcutaneous injection of efgartigimod alfa and hyaluronidase. It works by blocking harmful IgG antibodies involved in CIDP. Vyvgart enhances patient convenience with an easy administration route.
The approval of these drugs offers additional treatments for those who suffer from CIDP disease.
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Life Expectancy and Quality of Life
CIDP is not fatal. Various treatment options are available to help manage the disease. Even though patients have a life expectancy comparable to those without the disease, their quality of life can be significantly affected.
The longer the disease remains untreated, the greater the risk of permanent nerve damage, which can severely impair sensory and motor functions. If severe nerve damage sets in, patients may require assistance with daily living activities due to a lack of mobility.
Even with an accurate diagnosis and appropriate treatment, some patients with CIDP disease may still experience symptoms such as fatigue, pain, or sensory disturbances.
Supportive Strategies
Fortunately, in addition to different CIDP treatments, there are other things you can do on your own to make living with this condition easier, such as:
- Getting plenty of sleep to help manage fatigue
- Avoiding overexertion and taking frequent rests between activities
- Using assistive devices such as canes and walkers to help with mobility
- Making home modifications like installing raised toilet seats or grab bars
- Engaging in light exercise (after consulting your health professional first)
- Maintaining a healthy, balanced diet to get proper nutrients for promoting nerve health
These simple tips can help you manage CIDP disease while simultaneously receiving medical treatment and physical therapy.
Get Started with CIDP Treatments at AmeriPharma® Specialty Pharmacy
The sooner you identify CIDP and begin treatment, the higher the chance you can reverse symptoms and prevent further nerve damage.
If you are diagnosed with CIDP and require treatment to manage the disease, AmeriPharma® Specialty Pharmacy can help. Our ACHC-accredited specialty pharmacy provides hard-to-find medications and at-home treatments for CIDP patients.
We service 40+ U.S. states and territories with full-service coordination, copay assistance, and 24/7/365 support. Book a call today to talk to a specialist and learn more about our CIDP treatment options.
