Cyclophosphamide for Treatment of Refractory Chronic Inflammatory Demyelinating Polyradiculoneuropathy: A Systematic Review and Meta-analysis

Xiang, Qilang; Cao, Yuzi; Song, Zhuoyao; Chen, Huini; Hu, Ziyi; Zhou, Shu; Zhang, Yan; Cui, Hongxu; Luo, Jianxun; Qiang, Yiying; Wang, Ye; Shuai, Shiquan; Yang, Yuan; Yang, Min; Wei, Xin; Xiong, Anji

doi:10.1016/j.clinthera.2022.06.008

Cited by 2 publications

(2 citation statements)

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“…61 Amelioration was achieved within a mean of 4 months, complete remission in 11/15 (73.3%). Other reports of smaller series indicated subsequently similar results, in addition to, as detailed in recent systematic review and meta-analysis 62 , an unpublished conference abstract from China reporting an 88% responder-rate in 32 treated subjects. As a result, cyclophosphamide is today frequently utilized as first immunosuppressant in severe, refractory CIDP, in many centres.…”

Section: Immunosuppression For Cidpsupporting

confidence: 58%

“…However, it is noteworthy that the latest meta-analysis indicated associated corticosteroid therapy did not bring additional benefit. 62 Repeating treatment with cyclophosphamide requires careful consideration of the side-effect risk versus the limited evidence base. Rituximab is given in CIDP in doses of 2 g in total over 2 weeks or 375 mg/m 2 administered weekly for 4 weeks.…”

Section: Immunosuppression For Cidpmentioning

confidence: 99%

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Chronic Inflammatory Demyelinating Polyradiculoneuropathy: Current Therapeutic Approaches and Future Outlooks

Rajabally

2024

ITT

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Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a treatable autoimmune disorder, for which different treatment options are available. Current first-line evidence-based therapies for CIDP include intravenous and subcutaneous immunoglobulins, corticosteroids and plasma exchanges. Despite lack of evidence, cyclophosphamide, rituximab and mycophenolate mofetil are commonly used in circumstances of refractoriness and, more debatably, of perceived overdependence on first-line therapies. Rituximab is currently the object of a randomized controlled trial for CIDP. Based on case series, and although rarely considered, haematopoietic autologous stem cell transplants may be effective in refractory disease, with low mortality and high remission rates. A new therapeutic option has appeared with efgartigimod, a neonatal Fc receptor blocker, recently shown to significantly lower relapse rate versus placebo, after withdrawal from previous immunotherapy. Other neonatal Fc receptor blockers, nipocalimab and batoclimab, are under study. The C1 complement-inhibitor SAR445088, acting in the proximal portion of the classical complement system, is currently the subject of a new study in treatment-responsive, refractory and treatment-naïve subjects. Finally, Bruton Tyrosine Kinase inhibitors, which exert anti-B cell effects, may represent another future research avenue. The widening of the therapeutic armamentarium enhances the need for improved evaluation of treatment effects and reliable biomarkers in CIDP.

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Section: Immunosuppression For Cidpsupporting

confidence: 58%

Section: Immunosuppression For Cidpmentioning

confidence: 99%