Randomized controlled trial of intravenous immunoglobulin versus oral prednisolone in chronic inflammatory demyelinating polyradiculoneuropathy

This multicenter, randomized, double-blind, crossover trial compared a six week course of oral prednisolone tapering from 60 mg to 10 mg daily with in travenous immunoglobulin (IVIg) 2.0 g/kg given over one to two days for tre ating chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Twe nty-four of the thirty-two randomized patients completed both treatment per iods. Both treatments produced significant improvements in the primary outc ome measure, change in an 11-point disability scale two weeks after randomi zation. There was slightly, but not significantly, more improvement after M g than with prednisolone, the mean difference between the groups in change in disability grade being 0.16 (95% CI = -0.35 to 0.66). There were also sl ightly, but not significantly, greater improvements favoring Mg in the seco ndary outcome measures: time to walk 10 meters after two weeks and improvem ent in disability grade after six weeks. Results may have been biased again st Mg by the eight patients who did not complete the second arm of the tria l. A serious adverse event (psychosis) attributable to treatment occurred i n one patient while on prednisolone and in none with Mg.