Natalizumab as a Disease-Modifying Therapy in Chronic Inflammatory Demyelinating Polyneuropathy - A Report of Three Cases.

Abstract:

BACKGROUND:Several treatments are available to treat the immune-mediated chronic inflammatory demyelinating polyneuropathy (CIDP). Among these treatments, intravenous immunoglobulins, corticosteroids and plasma exchanges are validated and widely used. A few immunosuppressive drugs have been tried, but they had little efficiency. METHODS:We describe three CIDP patients treated by Natalizumab (acting against cellular adhesion and T-cell migration) after a failure of the validated treatments. RESULTS:We observed a long-term improvement in one patient, a dramatic improvement over a significant duration in another patient and stabilization in the last one. CONCLUSION:This open label study provides evidence for the value of Natalizumab as second-line treatment for individual patients with a high dependency on waning efficacy of first-line therapies. CIDP is characterized by heterogeneity of clinical phenotypes, electrophysiological and pathological features, and various variable courses types of evolution. The different responses to drugs of our patients are consistent with some reported cases and may reflect the spectrum of lesional mechanisms and the molecular dysfunctions in CIDP.

journal_name

Eur Neurol

journal_title

European neurology

authors

Vallat JM,Mathis S,Ghorab K,Milor MA,Richard L,Magy L

doi

10.1159/000381767

subject

Has Abstract

pub_date

2015-01-01 00:00:00

pages

294-302

issue

5-6

eissn

0014-3022

issn

1421-9913

pii

000381767

journal_volume

73

pub_type

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