• D Cocito, S Grimaldi, I Paolasso, Y Falcone, G Antonini, L Benedetti, C Briani, R Fazio, S Jann, S Matà, M Sabatelli, E Nobile-Orazio, and Italian Network for CIDP Register.
• Dipartimento di Neuroscienze, AOU San Giovanni Battista, Torino, Italy. dariococito@yahoo.it
• Eur. J. Neurol. 2011 Dec 1; 18 (12): 1417-21.

Background And PurposeThere are other options open to patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) who are non-responders to conventional treatment, including immunosuppressive and immunomodulatory agents (IA). The aim of this study was to assess whether the use of IA is able to increase the number of responders.MethodsClinical and electrophysiological data of patients with refractory CIDP, followed at 10 Italian centres, were collected, and the clinical outcome (Rankin Scale) and drug side effects (SE) for the different therapies were analysed.ResultsA total of 110 patients were included. These patients underwent 158 different therapeutic procedures with IA. Seventy-seven patients were treated with azathioprine, 18 rituximab, 13 cyclophosphamide, 12 mycophenolate mofetil, 12 cyclosporine, 12 methotrexate, 11 interferon-alpha and three interferon beta-1a. The percentage of patients who responded to azathioprine (27%) was comparable to the percentage of responders to other therapies, after the exclusion of interferon beta-1a that was not effective in any of the three patients treated. The percentage of SE ranges from 8% (methotrexate) to 50% (cyclosporine).ConclusionsOne-fourth of patients, refractory to conventional treatment, showed an improvement in their disability with IA. Methotrexate had the lowest SE; cyclosporine was associated with severe SE and often led to drug discontinuation.© 2011 The Author(s). European Journal of Neurology © 2011 EFNS.

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