IVIG, Steroids or Plasma Exchange for CIDP: How the Three Treatments Differ

The neurologist has drawn three columns on a sheet of paper. The person across the desk, who six months ago could carry two bags of groceries up a flight of stairs and now grips the banister with both hands, is looking at the words in each column and trying to work out which one is the right answer. There does not appear to be one.

That is the honest starting point for anyone weighing ivig vs plasma exchange for cidp, or either of those against a course of steroids. All three have been used for decades. All three appear in every major guideline as reasonable first choices. And the research that pitted them directly against one another is thin, old and inconclusive on the question people most want answered, which is: which one will work for me?

What the evidence does offer is a clear picture of how each treatment works, how fast it acts, how long it lasts and what it asks of the person receiving it. Those differences, not a league table, are what shape the decision.

What CIDP is, and why there are three treatments to choose from

Chronic inflammatory demyelinating polyneuropathy is a condition in which the immune system attacks myelin, the fatty insulating sheath wrapped around peripheral nerves. Peripheral nerves are the ones that run from the spinal cord out to the arms, legs and trunk. When their insulation is stripped, electrical signals slow down or fail, and the result is weakness, numbness, tingling and unsteadiness that typically affect both sides of the body.

The word chronic matters. The National Institute of Neurological Disorders and Stroke describes CIDP as a condition in which symptoms keep progressing for at least eight weeks, which separates it from Guillain-Barré syndrome, a related illness that peaks within about four weeks and then stops worsening on its own. CIDP does not stop on its own for most people, which is why treatment is offered rather than waited out.

Because the damage is driven by the immune system, and because myelin can regrow once the attack is dampened, every established treatment aims at the same target from a different angle. Intravenous immunoglobulin, usually shortened to IVIG, floods the bloodstream with donated antibodies that appear to interfere with the harmful ones. Corticosteroids switch down inflammation broadly across the immune system. Plasma exchange physically removes the liquid part of the blood, and the antibodies floating in it, and replaces it.

Three treatments exist not because one failed and was replaced, but because each arrived from a different corner of medicine and each was shown, in trials, to beat no treatment in the short term. The Cochrane systematic reviews covering IVIG, steroids and plasma exchange all reach a similar conclusion: the treatment works better than nothing, and the evidence comparing it to the alternatives is too limited to declare a winner. So the decision becomes practical, personal and clinical rather than a matter of ranking.

How IVIG works for CIDP, in plain language

Immunoglobulin is another word for antibody, the protein the immune system makes to recognise and tag things it wants removed. IVIG is a concentrated solution of these antibodies collected from the plasma of many thousands of healthy blood donors, pooled, purified, treated to inactivate viruses and then given slowly into a vein over several hours.

Exactly how a bag of other people’s antibodies calms an autoimmune attack is still debated. The leading explanations include blocking the harmful antibodies from reaching their target on the nerve, soaking up complement proteins that would otherwise punch holes in myelin, and adjusting the receptors on immune cells so they become less aggressive. Several of these effects probably happen at once, which may be why IVIG helps in a range of immune-mediated nerve conditions rather than just one.

The Cochrane review of IVIG for CIDP, which combined data from randomised trials against placebo, found that IVIG improved disability more than placebo for at least two to six weeks after a course. That timeframe is the key to understanding how IVIG is used in practice. The infused antibodies are gradually broken down by the body, and the underlying immune process has not been switched off, so the benefit fades. Most people who respond need repeated courses on a schedule set by their neurologist, and that schedule is adjusted over time based on how the person is doing rather than fixed in advance.

Infusions can be given in a hospital day unit, an outpatient infusion centre or, in many health systems, at home with a visiting nurse. A related option, immunoglobulin given under the skin rather than into a vein, exists as a maintenance approach for some people once they have responded; whether it suits a particular person is a conversation for the prescribing team.

How corticosteroids work for CIDP, and why they take longer

Corticosteroids are synthetic relatives of cortisol, the hormone the adrenal glands release in response to stress. In the immune system they act like a dimmer switch rather than an on-off button: they enter cells, bind to receptors and turn down the activity of genes that drive inflammation, which quietens the white blood cells and chemical messengers involved in attacking myelin.

For CIDP, steroids are given either as a daily tablet or as intermittent high-dose pulses by mouth or into a vein, with gaps between pulses. The Cochrane review of corticosteroids for CIDP found only limited trial evidence: one small older trial suggested that people on steroids improved more than those on no treatment, and a later trial comparing daily oral steroid with monthly pulses found no clear difference between the two schedules in how many people improved. The reviewers graded the overall evidence as low quality, which does not mean steroids do not work, but does mean the size of the benefit is uncertain.

The defining feature of steroids in CIDP is timing. Improvement, when it comes, usually takes weeks to months rather than days. That makes steroids a poor fit for someone whose weakness is worsening quickly and a more reasonable option for someone with a slower course who prefers a treatment taken at home without needles, infusion appointments or machines.

Two cautions shape how neurologists use them. First, long courses accumulate side effects, discussed later, so the aim is usually to reach the lowest effective amount and to taper off once the condition is controlled. Second, steroids are generally avoided in the purely motor form of CIDP, where some people have worsened on them. Anyone taking steroids should never stop abruptly, because the adrenal glands need time to resume their own cortisol production; any change is planned with the prescriber.

What actually happens during plasma exchange (plasmapheresis)

Plasma is the pale yellow liquid portion of blood in which red cells, white cells and platelets are suspended. It carries clotting factors, proteins and, crucially for CIDP, antibodies. Plasma exchange removes that liquid and replaces it. The word plasmapheresis is used almost interchangeably in everyday conversation, and in this article the two mean the same procedure.

The person sits or lies in a chair for a couple of hours. Blood leaves the body through a needle or catheter in one arm, passes through a machine that separates cells from plasma either by spinning or by filtration, and the cells are returned through a second line mixed with replacement fluid. The replacement is most often a solution of albumin, a purified blood protein, sometimes combined with saline. A small amount of anticoagulant, usually citrate, is added to the tubing so the blood does not clot inside the machine.

Good venous access is essential. Some people can be treated through veins in the arms; others need a temporary central venous catheter placed in a large vein in the neck, chest or groin. That requirement is one of the main practical differences between plasma exchange and IVIG.

A course is not a single session. Several exchanges are spread over days to weeks, because antibodies stored in tissues drift back into the bloodstream between sessions and need removing again. The Cochrane review of plasma exchange for CIDP, drawing on two small trials, found that it produced short-term improvement in disability, clinical impairment and nerve conduction compared with sham exchange, and noted that rapid deterioration can follow when the exchanges stop. For that reason plasma exchange is often used to bring a worsening situation under control quickly, with another treatment taking over for the longer term.

IVIG vs plasma exchange for CIDP: what the head-to-head trials show

Here is the answer to the question in the title, stated as plainly as the evidence allows. Only one randomised trial has directly compared IVIG with plasma exchange in CIDP. It was small, it used a crossover design in which each person received both treatments in turn, and it found no significant difference in disability improvement between them. Both the Cochrane review of IVIG and the Cochrane review of plasma exchange report this same finding and grade the certainty as low because of the trial’s size.

So the honest position is that the two treatments appear similarly effective in the short term, and that a much larger trial would be needed to detect any real difference if one exists. Neither guideline bodies nor systematic reviewers claim that one is superior for CIDP as a whole.

The differences that actually drive the choice are practical, and they are real:

• IVIG needs an ordinary intravenous line; plasma exchange needs robust venous access and sometimes a central catheter.
• IVIG can be given at home in many systems; plasma exchange requires a machine and trained apheresis staff, so it is almost always done in a hospital or specialist unit.
• IVIG’s benefit lasts at least two to six weeks per course according to the Cochrane review; plasma exchange’s benefit tends to fade within weeks once exchanges stop and is rarely used alone for long-term maintenance.
• IVIG depends on a supply of donated plasma and has periodically been in short supply; plasma exchange depends on equipment and staffing.
• Their side-effect profiles differ, as covered in a later section, and a person’s other health conditions can tip the balance either way.

In practice, plasma exchange is often chosen when IVIG is unavailable, has not helped, has caused problems, or when a rapid effect is needed and the person has suitable veins. Which of those situations applies is a judgment for the treating team.

CIDP steroids vs IVIG: is either the most effective treatment for CIDP?

Two trials summarised in the Cochrane IVIG review compared IVIG directly with corticosteroids, one against daily oral prednisolone and one against intravenous methylprednisolone pulses. Neither found a significant difference in short-term disability improvement. That puts steroids on the same evidentiary footing as IVIG and plasma exchange: effective compared with nothing, not proven better or worse than the alternatives.

The differences appear in the details. In the trial comparing IVIG with intravenous steroid pulses, more people stopped the steroid early, either because it was not helping or because of side effects, but among those who did respond and then finished treatment, relapse in the following months was less frequent after steroids than after IVIG. That pattern, harder to tolerate but possibly longer-lasting once it works, is consistent with how neurologists describe steroids in clinic, though a single trial cannot settle it.

Which brings us to the search that thousands of people type every month: what is the most effective treatment for CIDP? The most defensible answer from the evidence is that there is no single most effective treatment for the condition as a whole. There is only the treatment that a particular person responds to, tolerates and can realistically continue. Some people improve substantially on IVIG and not on steroids; others show the reverse. Response cannot yet be predicted reliably from a test before starting.

What guidelines and reviews agree on is the shape of the approach: start with one of the three, judge the response with objective measures of strength and function over an agreed period, and switch or add if the response is inadequate. Effectiveness, in CIDP, is discovered rather than looked up.

IVIG vs plasma exchange for CIDP at a glance: the comparison table

Words spread across several sections can blur. The table below pulls the practical differences into one place. The entries describe typical patterns reported in the Cochrane reviews and by the National Institute of Neurological Disorders and Stroke; individual experiences vary, and none of the timings is a promise.

Feature	IVIG	Corticosteroids	Plasma exchange
What it does	Adds pooled donor antibodies that interfere with the immune attack	Turns down inflammation across the immune system	Physically removes plasma and the antibodies in it
How it is given	Into a vein over hours; home infusion possible in many systems	Tablets at home, or pulses by mouth or vein	Machine-based sessions in hospital; needs good vein access, sometimes a central line
How quickly it usually acts	Weeks	Weeks to months	Days to weeks
How long one course lasts	At least 2–6 weeks (Cochrane)	Ongoing while taken; effect may persist after taper in responders	Fades within weeks after exchanges stop (Cochrane)
Typical role	First-line induction and maintenance	First-line, especially slower course; long-term use limited by side effects	Rapid control, or when IVIG unavailable or ineffective; rarely sole maintenance
Main practical burden	Repeated infusion appointments; supply issues	Daily medicine; monitoring of blood sugar, bone, blood pressure	Hospital visits; venous access; staffing
Head-to-head evidence	No significant difference in short-term disability improvement in the small trials comparing any two of the three

Reading down the columns, the pattern is speed and convenience traded against durability and burden. Plasma exchange and IVIG win on speed; steroids win on convenience and possibly on how long a response lasts after stopping; each carries a different set of risks. No column is empty of drawbacks, which is precisely why the decision belongs in a consultation rather than a table.

Who is usually offered which treatment, and who is asked to wait

Neurologists tend to start from three questions: how fast is this person getting worse, what else is going on in their body, and what can they practically manage?

Speed comes first. Someone whose walking has deteriorated over a few weeks, or who is losing hand function quickly, is usually offered IVIG or plasma exchange, because both act within weeks and steroids may not. Someone with a slow, grumbling course over many months has more room to try steroids if that suits them.

Other conditions shape the list. Poorly controlled diabetes, osteoporosis, uncontrolled high blood pressure, glaucoma or a history of steroid-related mood problems make long steroid courses less attractive. Heart failure, kidney disease or a history of blood clots make the treating team cautious with IVIG, which adds fluid volume and thickens the blood slightly. Very low blood pressure, a bleeding tendency, fragile veins or an active infection make plasma exchange harder or riskier. The purely motor form of CIDP steers teams away from steroids.

Practical life matters too. A person who lives far from an apheresis unit, or who cannot take regular days off, may find repeated plasma exchange unworkable. Someone who fears needles or has poor veins may prefer tablets. These are legitimate factors, not soft ones.

Some people are asked to wait. Watchful monitoring is sometimes chosen when symptoms are mild, mainly sensory and not affecting daily function, because every treatment carries risk and CIDP can plateau. Waiting is also common when the diagnosis is not yet secure; nerve conduction studies, a lumbar puncture and blood tests to exclude mimics such as hereditary neuropathies or blood protein disorders may come first, because committing to long-term immune therapy for the wrong condition helps no one. In every case, the decision to start, wait or switch rests with the treating team and the person in front of them.

How risky is plasmapheresis, and what are the side effects of IVIG and steroids?

People searching this question often expect one treatment to be safe and the others dangerous. The truth is that all three are generally well tolerated in experienced hands, and all three have a recognisable list of problems worth knowing in advance.

Plasma exchange side effects come mostly from the mechanics. Removing and returning large volumes of fluid can drop blood pressure, causing light-headedness or faintness during a session. The citrate anticoagulant temporarily binds calcium, which some people feel as tingling around the mouth or in the fingers; the team can adjust the procedure if this happens. Bleeding, bruising or infection can occur where the line enters, and central catheters carry their own risks of clot, infection or, rarely, injury during placement. Allergic reactions to replacement fluid are uncommon but possible. The Cochrane review noted adverse events in the trials but described the procedure as generally safe when performed by trained staff.

IVIG side effects are usually mild and short-lived: headache is the most common, along with flu-like aches, chills, nausea or a rash during or after the infusion. Slowing the infusion and good hydration reduce them. Less common but more serious problems include aseptic meningitis, a severe headache with stiff neck that is not caused by infection, kidney strain, blood clots and breakdown of red blood cells. People with existing kidney or heart disease are monitored more closely.

Steroid side effects accumulate with time rather than appearing on the day. Sleep disturbance, mood change, increased appetite and weight change, raised blood sugar and blood pressure, stomach irritation, thinning of the skin and bones, cataracts and greater susceptibility to infection are all well documented. Teams typically monitor blood pressure, blood glucose and bone health and may add protective measures, decided case by case. None of these lists is a reason to refuse treatment; each is a reason to ask which risks matter most for you.

What the days and weeks after starting treatment usually look like

The first course is mostly logistics. With IVIG, that means one or several long infusion days in a row, often with a mild headache or tiredness that evening. With plasma exchange, it means a run of sessions over a couple of weeks, each a few hours long, interspersed with normal days. With steroids, it means a new routine of tablets and, for pulse regimens, occasional intense days.

The middle weeks are about watching. Neurologists rarely rely on how a person feels alone, because fatigue and mood fluctuate. They use grip strength meters, timed walking tests, standardised disability scales and sometimes repeat nerve conduction studies to track change. For IVIG and plasma exchange, meaningful improvement is usually judged over the first few weeks; the Cochrane IVIG review found benefit lasting at least two to six weeks after a course, which is why the follow-up appointment often falls within that window. For steroids, the team generally waits considerably longer before deciding whether the treatment is working.

Fading is expected, not failure. Many people on IVIG notice that strength dips toward the end of a cycle and picks up after the next infusion. Recording those changes in a simple diary helps the team tune the interval. Plasma exchange responders are usually moved onto another treatment for maintenance because the effect is short. Steroid responders begin a slow taper once stable, with the pace set by the prescriber and stretched over months.

Rehabilitation runs alongside all of this. Physiotherapy to maintain range of movement and rebuild strength, occupational therapy for hand function, and attention to falls prevention are part of standard care regardless of which drug is chosen. Recovery of function depends on myelin repair and, where axons have been damaged, on slower nerve regrowth, so improvement can continue for months after inflammation is controlled.

What if IVIG doesn't work for CIDP?

A meaningful proportion of people do not improve on IVIG, and the first response from a good team is not to reach for the next drug but to ask two questions.

Is the diagnosis right? Several conditions mimic CIDP and respond poorly to immunoglobulin: hereditary neuropathies, neuropathy linked to diabetes or to abnormal blood proteins, and a group of neuropathies caused by antibodies against proteins at the nodes of Ranvier, the tiny gaps between myelin segments. These nodal and paranodal antibody neuropathies are now recognised as distinct, and people who have them frequently show little benefit from IVIG. Blood tests and a fresh look at the nerve conduction pattern can identify them.

Was the trial of IVIG adequate? Response can take more than one cycle, and an interval that is too long may let strength fall before the next infusion. The team will usually confirm that enough courses were given over enough time before concluding that the treatment has failed.

If IVIG genuinely is not working, the pathway is well established:

• Switching to corticosteroids or plasma exchange, since a person who does not respond to one first-line treatment may respond to another.
• Combining treatments, for example plasma exchange to regain control followed by a different maintenance approach.
• Adding an immunosuppressant medicine. Drugs such as azathioprine, mycophenolate, cyclophosphamide and rituximab have all been used; the Cochrane reviews on these agents describe the trial evidence as limited, so they are typically considered case by case.
• Newer antibody-lowering medicines that block the neonatal Fc receptor, a protein that recycles antibodies in the blood, have been studied in CIDP and are a topic for discussion with a neurologist.
• Referral to a specialist neuromuscular centre or enrolment in a clinical trial.

Throughout, rehabilitation continues, because function can be preserved and rebuilt even while the right immune treatment is still being found.

What people often get wrong about CIDP treatment

Misunderstandings about CIDP treatment are common enough to be worth correcting one by one.

IVIG fixes the condition. It does not. IVIG treats the immune attack for as long as it is in the body, which is why benefit fades over weeks and courses are repeated. The underlying tendency to attack myelin is controlled, not removed, though some people do eventually enter a remission that lets treatment be spaced out or paused under supervision.

Plasma exchange cleans the blood permanently. Antibodies are produced continuously by immune cells that plasma exchange does not touch, so removed antibodies are replaced within weeks. That is why the Cochrane review describes rapid deterioration after exchanges stop and why the procedure is usually paired with something else.

Steroids are the old-fashioned, inferior option. The head-to-head trials found no significant difference in short-term improvement between steroids and IVIG. Steroids are slower and carry cumulative side effects, but for the right person they are a legitimate first choice, not a fallback.

If one treatment fails, none will work. Responses to the three treatments are not tightly linked. Someone who does not improve on IVIG may improve on steroids or plasma exchange, and the reverse.

You can stop once you feel stronger. Stopping abruptly, particularly steroids, can cause relapse or adrenal problems. Every reduction is planned and monitored.

IVIG comes from a single donor and can transmit infection. It is pooled from thousands of screened donors and undergoes purification and viral inactivation steps; transmission of known viruses through modern preparations is considered exceedingly rare.

Plasmapheresis and IVIG are basically the same thing. They are almost opposites: one removes antibodies, the other adds them. That they can both help the same condition says something about how many ways there are to interrupt an immune attack.

Questions to ask your care team

A consultation about CIDP treatment moves quickly and covers a lot. Writing questions down beforehand, and bringing someone to take notes, turns a bewildering appointment into a useful one. The following questions come up repeatedly in patient forums and clinic rooms and are worth putting to the team directly.

• How confident are you in the diagnosis, and have mimics such as hereditary or antibody-defined neuropathies been excluded?
• How quickly am I worsening, and does that speed favour a fast-acting treatment?
• Which of my other health conditions makes any of the three options riskier for me?
• How will you measure whether the treatment is working, and how long will you wait before deciding?
• If we choose IVIG, will infusions be in hospital or at home, and how will the interval be adjusted?
• If we choose plasma exchange, will I need a central line, and what is the plan for maintenance afterwards?
• If we choose steroids, what monitoring will I have for blood sugar, blood pressure and bone health, and how will tapering be handled?
• What symptoms should prompt me to call between appointments, and who do I call?
• What is the plan if the first treatment does not work?
• Should I be referred to a neuromuscular specialist or considered for a clinical trial?
• What physiotherapy or occupational therapy should run alongside the medicine?
• Is there any prospect of reducing or pausing treatment in the future, and how would that be decided?

Not every question will have a firm answer, and a team that says so honestly is a team worth trusting. The aim is not to arrive at a treatment you have chosen alone, but to understand the reasoning behind the one you and your neurologist choose together, so that when the first weeks bring a headache, a dip in strength or a side effect, you know whether it is expected or a reason to pick up the phone.

When to call your doctor

Most of what happens during CIDP treatment is unremarkable, but a handful of situations need same-day contact with the treating team, and a few need emergency services.

Call emergency services or go to the nearest emergency department if you experience any of the following:

• Difficulty breathing, shortness of breath at rest, or trouble swallowing, which can signal that weakness is reaching the muscles of breathing and swallowing.
• Chest pain, sudden breathlessness or a painful swollen leg, which can indicate a blood clot, a recognised risk with IVIG and with central venous catheters.
• Severe headache with a stiff neck, fever or sensitivity to light in the days after IVIG, which can indicate aseptic meningitis.
• Fainting, confusion or a very fast or irregular heartbeat during or after plasma exchange.

Contact your neurology team the same day if you notice:

• Weakness worsening noticeably over days rather than weeks, new falls, or loss of the ability to do something you could do the previous week.
• Fever, redness, warmth or discharge around a catheter or infusion site.
• On steroids: black or bloody stools, severe abdominal pain, marked thirst and frequent urination suggesting high blood sugar, sudden vision change, or a significant change in mood or thinking.
• A rash, hives, wheeze or facial swelling during or after any infusion.
• Persistent vomiting, or reduced urine output, after IVIG.

Less urgent but still worth a call: strength consistently dipping before the next scheduled treatment, new or worsening numbness, side effects that make you consider stopping a medicine, or any change you cannot explain. Do not stop or alter a prescribed treatment on your own; ring the team and describe what is happening. They would far rather hear about a false alarm than miss a real one.

Frequently asked questions

Plasmapheresis vs IVIG for CIDP: which is better?

Neither has been shown to be better. The one randomised trial comparing them directly, summarised in the Cochrane reviews of both treatments, found no significant difference in short-term disability improvement. The choice usually turns on practical factors: IVIG can often be given at home and lasts several weeks per course, while plasma exchange needs hospital equipment and vein access but can act very quickly.

What is the most effective treatment for CIDP?

There is no single most effective treatment for CIDP as a whole. IVIG, corticosteroids and plasma exchange are all first-line options, each beat no treatment in trials, and none has proven superior to the others. Individuals respond differently, and response cannot yet be predicted before starting, so neurologists choose based on speed of decline, other health conditions and practicality, then switch if needed.

How risky is plasmapheresis for CIDP?

Plasma exchange is generally considered safe when performed by trained staff, but it is not risk-free. Common problems include a drop in blood pressure, light-headedness and tingling from temporarily lowered calcium. Less common risks include bleeding or infection at the access site, allergic reaction to replacement fluid and, where a central catheter is used, clot or infection related to the line.

What if IVIG doesn't work for CIDP?

The team usually rechecks the diagnosis first, because conditions such as nodal antibody neuropathies mimic CIDP and respond poorly to IVIG. They also confirm that enough courses were given. If IVIG has genuinely failed, options include switching to steroids or plasma exchange, combining treatments, adding an immunosuppressant, considering newer antibody-lowering medicines, or referral to a specialist centre or clinical trial.

How quickly do steroids work for CIDP?

Slowly, compared with the alternatives. Improvement on corticosteroids typically takes weeks to months, which is why they are less often chosen for someone worsening rapidly. The Cochrane review of steroids for CIDP found limited trial evidence and no clear difference between daily oral and monthly pulse schedules. Neurologists usually wait considerably longer before judging a steroid response than an IVIG response.

How long does IVIG last in CIDP?

According to the Cochrane review of IVIG for CIDP, a course improves disability for at least two to six weeks compared with placebo. The infused antibodies are gradually broken down and the underlying immune process continues, so benefit fades. Most responders need repeated courses, with the interval adjusted by the neurologist based on when strength begins to dip before the next infusion.

Can you switch from IVIG to plasma exchange?

Yes, switching in either direction is part of standard practice. Plasma exchange is often used when IVIG is unavailable, has not helped or has caused problems, and IVIG or another treatment usually takes over for maintenance after a course of exchanges. Because the treatments work by opposite mechanisms, the team plans the timing carefully so one does not simply remove the other.

Is CIDP treatment lifelong?

Not always, but often long-term. CIDP is a chronic condition and treatment controls rather than removes the immune tendency, so many people continue maintenance therapy for years. Some enter remission and, under supervision, have treatment spaced out or paused. Decisions to reduce or stop are made gradually by the treating team with objective monitoring, never abruptly and never by the patient alone.

Do steroids or IVIG have more side effects in CIDP?

They have different side effects rather than simply more or fewer. IVIG problems are usually short-lived: headache, flu-like symptoms, rash, and rarely aseptic meningitis, kidney strain or clots. Steroid problems accumulate with time: sleep and mood change, raised blood sugar and blood pressure, bone thinning, cataracts and infection risk. In one trial, people stopped steroids early more often than IVIG.

Can plasma exchange and IVIG be given together for CIDP?

They are sometimes used in sequence rather than at the same moment, since plasma exchange would remove infused immunoglobulin. A common pattern is a course of exchanges to regain control quickly, followed by IVIG or another treatment for maintenance. Whether combining approaches makes sense for an individual, and how to time them, is a decision for the treating neurology team.

References

• Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) – National Institute of Neurological Disorders and Stroke (NIH)
• Chronic inflammatory polyneuropathy – MedlinePlus Medical Encyclopedia

This article is for general information only and is not a substitute for professional medical advice. Please consult a qualified doctor about your individual situation.