Chronic inflammatory demyelinating polyradiculoneuropathy: long-term course and treatment of 60 patients

The objective of this study was to assess the long-term course and treatmen t of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). We e valuated, according to a predefined protocol, a series of 60 CIDP patients who received a long-term course of steroids and immunosuppressants. Eightee n of them also had monoclonal gammopathy of undetermined significance (MGUS ). Mean follow-up was 4.4 years and was similar for CIDP and CIDP-MGUS pati ents. At the end of the follow-up, improve ment was ascertained in 60% of p atients (69% CIDP, 39% CIDP-MGUS). Complete remission was achieved in 13%. Out of 26 patients receiving steroids as a monotherapy, 19 improved (73%). The following variables were predictive of a better outcome: female gender, younger age at onset, relapsing-remitting course, and absence of axonal da mage at neurophysiologic study. In the multivariate analysis, younger age a t onset and demyelination without axonal damage still retained an independe nt positive value.