Chronic inflammatory demyelinating polyneuropathy therapy reference (2026)

CIDP therapy in 2026 organises around three main approaches.

Intravenous immunoglobulin (IVIG): the most-used therapy. Effective for inducing and maintaining response in most patients. Maintenance dosing varies (typically every 2 to 4 weeks). Subcutaneous immunoglobulin (SCIG) is an alternative delivery route for selected patients allowing home self-administration.

Corticosteroids: oral prednisone or pulse intravenous methylprednisolone. Effective in many patients. Long-term use is limited by steroid-related side effects.

Plasma exchange (plasmapheresis): effective in selected patients, particularly for acute deterioration. Logistically demanding for ongoing maintenance.

FcRn antagonist class: efgartigimod has CIDP approval. The mechanism (reducing circulating IgG including pathogenic autoantibodies) is well-suited to autoantibody-mediated neuropathy. Follow-on FcRn antagonist programs in CIDP are in late-stage trials, and the chronic-maintenance use case shapes the commercial trajectory.

Other immunosuppressants: rituximab, mycophenolate, methotrexate, azathioprine, and cyclophosphamide are used in selected patients, particularly for treatment-resistant disease.

Emerging mechanism programs: complement-targeted, B-cell-targeted, and additional mechanism programs in earlier-stage trials.

The diagnostic-pathway question matters. CIDP is often diagnosed late or misattributed to other neuropathies; standard diagnostic criteria combine clinical features, electrodiagnostic testing, and supportive findings (cerebrospinal fluid analysis, MRI, response to immunotherapy).