CIDPの治療—3つのmainstay治療をどのように組み立てるか

Treatment Strategies for Chronic Inflammatory Demyelinating Polyneuropathy

慢性炎症性脱髄性多発ニューロパチー（CIDP）の3種のmainstay治療について解説する。副腎皮質ステロイド薬，単純血漿交換および免疫グロブリン療法は，いずれも導入療法としての症状改善効果が認められている。われわれは副腎皮質ステロイド薬の経口連日投与，経口・点滴静注のパルス療法，血液浄化療法，免疫グロブリン大量静注療法と皮下注療法を組み合わせて導入療法から維持療法を行う必要がある。

Abstract

Three main treatments are available for management of chronic inflammatory demyelinating polyneuropathy (CIDP). Both induction and maintenance therapies should be considered for treatment of CIDP. Plasma exchange and intravenous immunoglobulin therapy are effective as induction treatments for CIDP, and corticosteroid administration, such as daily oral or pulse therapies, may be effective for both induction and maintenance. Recently, repeat intravenous or subcutaneous immunoglobulin infusion therapy has been introduced as maintenance treatment. Treatment strategies, including combinations of the aforementioned approaches, are required as induction and maintenance therapies for patients with CIDP.