Background

Chronic inflammatory demyelinating polyradiculoneuropathy is a peripheral neuropathy caused by peripheral nerve inflammation probably due to autoimmunity and would be expected to benefit from corticosteroids. Non‐randomised studies suggest that corticosteroids are often beneficial.

Objectives

To evaluate the efficacy of corticosteroids for treating chronic inflammatory demyelinating polyradiculoneuropathy.

Search methods

We searched the Cochrane Neuromuscular Disease Group Register (October 2007), MEDLINE (January 1966 to October 2007) and EMBASE (January 1980 to October 2007) for randomised trials of corticosteroids treatment for chronic inflammatory demyelinating polyradiculoneuropathy and made enquires of subject experts.

Selection criteria

Types of studies: All randomised or quasi‐randomised trials

Types of Participants: All patients with chronic inflammatory demyelinating polyradiculoneuropathy who were diagnosed by an internationally accepted definition.

Types of interventions: Treatment with any form of corticosteroids or adrenocorticotropic hormone.

Types of outcome measures:

Primary outcome measure: Change in disability 12 weeks after randomisation.

Secondary outcome measures:

(1) Change in impairment 12 weeks after randomisation.

(2) Change in maximum motor nerve conduction velocity or compound muscle action potential amplitude after 12 weeks.

(3) Side effects of corticosteroids.

Data collection and analysis

One author extracted the data and the other checked them.

Main results

In the first version of this review, we identified one randomised controlled trial, an open study in which 19 corticosteroids treated patients showed more improvement in impairment than 16 untreated controls after 12 weeks. In subsequent updates, including that in March 2008, we have not found any other randomised controlled trials. Experience from large non‐randomised studies suggests that steroids are beneficial.

Authors' conclusions

A single randomised controlled trial with 35 participants provided weak evidence to support the conclusion from non‐randomised studies that oral corticosteroids reduce impairment in chronic inflammatory demyelinating polyradiculoneuropathy. Corticosteroids are known to have serious long‐term side effects. The long‐term risk and benefits have not been adequately studied.