Intravenous immunoglobulin for the treatment of chronic inflammatory demyelinating polyradiculoneuropathy: a systematic review and meta-analysis

摘要: Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an acquired immune-mediated disorder that targets the myelin sheaths of peripheral nervous system. The motor weakness symptoms CIDP resemble those Guillain–Barre syndrome, but 2 disorders are arbitrarily differentiated by time to maximum deficit.1 Patients with reach clinical deficit about 8 weeks or more after onset symptoms, whereas patients syndrome within 3–4 weeks. In addition, a self-limited, monophasic illness, has prolonged course over months years, which may be steadily progressive relapsing–remitting.2 Given ambiguities diagnosing CIDP, true prevalence disease underestimated overestimated. Reported mean estimates from 6 studies ranged 0.46 7.7 per 100 000 population.3-8 vary age and sex, highest 3.12, 9.47 19.24 population having been reported for men 55 years older,8 70–79 age4 80 older,6 respectively. Regional differences same country have also reported.3,5 Prevalence incidence rates not Canada, it can assumed this will fall ranges in trials other countries similar demographic characteristics, such as England5 Australia:4 1.0–1.9 population. Patients shown improvement treatment corticosteroids plasma exchange,9,10 both therapies disadvantages. Because chronic nature disease, long-term use usually required, carries risk numerous adverse events, some serious.11 benefit exchange typically transient, therefore employed concomitantly form therapy.10 Plasma associated several effects, including anaphylactic reactions, cardiac arrhythmias death.12 Furthermore, must carried out specialized centres, repeated procedures require good vascular access.13 Intravenous immunoglobulin (IVIg) blood product containing G pooled many human donors. 2008, US Food Drug Administration14 Health Products Branch Canada15 granted Talecris Biotherapeutics supplemental licences its IVIg include indication. The objective systematic review published randomized controlled (RCTs) was evaluate effectiveness safety CIDP.