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Combined intravenous immunoglobulin and methylprednisolone as induction treatment in chronic inflammatory demyelinating polyneuropathy (OPTIC protocol): A prospective pilot study

European Journal of Neurology Jan 30, 2020

Adrichem ME, Bus SR, Wieske L, et al. - Among patients with chronic inflammatory demyelinating polyradiculoneuropathy receiving induction treatment with combined intravenous immunoglobulin (IVIg) and intravenous methylprednisolone (IVMP), researchers conducted this uncontrolled pilot study to assess remission, rate of improvement [defined as a minimal clinically important difference on the Inflammatory Rasch-Built Overall Disability Scale and/or an increase of ≥ 8 kPa in grip strength between baseline and week 18] and safety. Consecutive treatment-naive individuals with chronic inflammatory demyelinating polyradiculoneuropathy have been treated with IVIg infusions, consisting of a 2 g/kg loading dose and 1 g/kg maintenance treatment every 3 weeks, combined with 3-weekly 1-g IVMP infusions, for a total of 18 weeks. In total, 20 patients were involved and 17 completed the treatment schedule. In approximately 60% of patients who finished the treatment schedule, short-term combined induction treatment with IVIg and IVMP induced remission. Findings revealed that combined induction therapy was generally well tolerated. In order to confirm the effectiveness and safety of IVMP as add-on treatment to IVIg, a randomized controlled trial is currently running.
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