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

Abstract

This multicenter, randomized, double‐blind, crossover trial compared a 6 week course of oral prednisolone tapering from 60 mg to 10 mg daily with intravenous immunoglobulin (IVIg) 2.0 g/kg given over 1 to 2 days for treating chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Twenty‐four of the thirty‐two randomized patients completed both treatment periods. Both treatments produced significant improvements in the primary outcome measure, change in an 11‐point disability scale 2 weeks after randomization. There was slightly, but not significantly, more improvement after IVIg 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 slightly, but not significantly, greater improvements favoring IVIg in the secondary outcome measures: time to walk 10 meters after 2 weeks and improvement in disability grade after 6 weeks. Results may have been biased against IVIg by the 8 patients who did not complete the second arm of the trial. A serious adverse event (psychosis) attributable to treatment occurred in 1 patient while on prednisolone and in none with IVIg.