CYCLOSPORINE-A IN RESISTANT CHRONIC INFLAMMATORY DEMYELINATING POLYRADICULONEUROPATHY

The role of cyclosporin A (CsA) in the treatment of resistant chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) was retrospec tively reviewed in 19 patients who had failed to respond adequately to corticosteroids, plasmapheresis, intravenous immunoglobulin, and in s ome cases other immunosuppressive agents. Patients were subdivided int o progressive or relapsing types according to the course of disease an d response to therapy graded at follow-up by clinical and electrophysi ological criteria. In the progressive group, the mean disability statu s declined from 3.8 +/- 0.7 to 1.8 +/- 1.1 grades on a 5-grade scale f ollowing CsA therapy (P < 0.001). In the relapsing group, the mean ann ual incidence of relapse declined from 1.0 +/- 0.5 to 0.2 +/- 0.4 afte r commencement of CsA (P < 0.05). Dose-dependent, reversible nephrotox icity was the most serious complication of therapy, and necessitated c essation of CsA in 2 patients. In conclusion, CsA is an efficacious an d, with appropriate monitoring, safe therapy for patients with CIDP. ( C) 1998 John Wiley & Sons, Inc.