CIDP treatment focuses on reducing and slowing the immune processes damaging your peripheral nervous system. It includes corticosteroids, intravenous immunoglobulin, and plasma exchange, but new therapies are emerging.

Chronic inflammatory demyelinating polyneuropathy (CIDP) is an immune-mediated condition that affects the peripheral nervous system and the nerves outside your central nervous system (the brain and the spinal cord). Inflammation from immune dysfunction in CIDP and autoantibodies damage the protective myelin sheath around peripheral nerves, causing it to break down in what’s known as demyelination.

Your myelin sheath acts like an insulator around nerves. When it becomes damaged, the electrical signals along those nerves can slow, weaken, and sometimes fail to transmit messages completely. This can lead to symptoms of CIDP, like muscle weakness, numbness, and the loss of reflexes and sensory input.

Although CIDP can cause significant impairment, it is treatable, and as many as 40% of people reach a state of cure or remission with effective therapies.

As an immune-mediated condition, CIDP treatment involves therapies that modify or suppress immune responses in your body. The goal is to slow or stop the demyelination process and reduce inflammation, which helps prevent further damage. It also helps prevent nerve repair and proper function.

Intravenous immunoglobulin (IVIG) is an antibody therapy that helps boost your body’s natural immunity. It’s the go-to treatment for CIDP and is considered the gold standard, along with plasmapheresis and corticosteroid use.

The antibodies in IVIG neutralize the autoantibodies attacking your myelin sheath and suppress inflammatory substances that promote nerve damage.

IVIG is administered slowly through your vein as an infusion. The initial dose is typically given over 2 to 5 days, with a maintenance dose every few weeks or months, depending on your individual response.

Corticosteroids are medications with anti-inflammatory and immunosuppressive benefits. They mimic natural hormones in your body called glucocorticoids, which help support the immune system function.

Corticosteroids in CIDP help reduce active immune attacks on the myelin sheath and lower substances that increase inflammation, leading to nerve damage.

Your doctor may prescribe a corticosteroid you take by mouth daily on a tapering dose. You may also be a candidate for a monthly high dose injection.

Long-term corticosteroid use can increase your chance of experiencing negative side effects. Because of this, your doctor may eventually replace corticosteroids with a different immunosuppressive agent.

Plasmapheresis, also known as plasma exchange, replaces the liquid part of your blood called plasma with a substitute. Your natural plasma is where autoantibodies and other immune substances reside. Replacing it with a substitute eliminates the factors that can lead to an attack on the myelin sheath and an increase in inflammation.

If CIDP is severe or IVIG and corticosteroids aren’t enough to control immune responses in CIDP, doctors use plasma exchange in combination with IVIG.

During plasma exchange, a medical professional withdraws a portion of your blood and runs it through a machine that separates the blood cells from the plasma. The machine then mixes the remaining blood cells with a substitute fluid before returning it to your body. This process continues until it replaces a significant portion of your plasma.

A typical treatment for CIDP involves 5 to 10 sessions over the course of up to 4 weeks. If CIDP is difficult to manage, you may need maintenance plasma exchange sessions after the initial therapy.

In 2024, the Food and Drug Administration (FDA) approved Vyvgart Hytrulo, a new effective treatment for CIDP in adults. Vyvgart Hytrulo works by reducing the level of pathogenic (disease-causing) immunoglobulin G (IgG) antibodies in your bloodstream. IgG antibodies typically help your immune system fight infection, but in CIDP, some antibodies mistakenly attack the myelin sheath tissue.

This medication combines efgartigimod alfa with hyaluronidase.

Efgartigimod alpha is a neonatal Fc receptor blocker. It targets a specific receptor site on immune cells that keep pathogenic IgG antibodies recycling in your bloodstream. With this receptor site blocked, pathogenic IgG antibodies break down rather than recycle. This leads to lower levels in the body.

Hyaluronidase is an enzyme that boosts the absorption and spread of efgartigimod alfa when administered by injection under the skin (subcutaneously).

If your doctor prescribes this treatment, you’ll receive a weekly injection for 4 consecutive weeks.

Not everyone living with CIDP responds to first-line therapies or is a candidate for long-term corticosteroid or IVIG treatment.

If this is the case, your doctor may recommend alternative treatments with other immunosuppressive medications, such as:

  • methotrexate
  • cyclosporine
  • cyclophosphamide
  • rituximab
  • mycophenolate

Occupational therapy, physical therapy, and psychological support can also improve your overall quality of life with CIDP. These therapies focus on the necessities for everyday function, such as building and maintaining mobility, strength, independence, and coping skills.

If you’ve received a CIDP diagnosis, talking with your doctor can help you understand which treatment options are best for your individual needs.

If you’re curious about a different treatment, it can be helpful to write down your questions and bring the list to your appointment. You can also bring a loved one with you to listen. After the appointment, they can discuss your options with you or offer a different perspective.

If you’re not confident that your treatment plan is the best option even after discussing it with your doctor, it’s OK to seek a second or third opinion.

CIDP is an autoimmune condition that can significantly impair daily life. With effective treatment, a state of remission or a cure is possible for some people.

Intravenous immunoglobulin, corticosteroids, and plasmapheresis are the first-line therapies for CIDP, but new treatments are still in development. For example, Vyvgart Hytrulo is a newer medication for treating CIDP in adults.

If you’re living with CIDP and want to know more about the treatment options available, speak with your doctor to learn which therapies are recommended and why they may or may not be appropriate for your needs.