Pulsed high dose dexamethasone treatment in chronic inflammatory demyelinating polyneuropathy: a pilot study

Six cycles of dexamethasone (40 mg per day for four sequential days) every 28 days induced remissions in 10 patients with idiopathic thrombocytopenic purpura (ITP). Whether the same results could be achieved in 10 patients with chronic inflammatory demyelinating polyneuropathy (CIDP) was investigated by comparing the Rivermead mobility index (RMI) before and after six cycles of treatment. Three patients discontinued treatment: one because of severe nausea and vomiting and two because of neurological deterioration. All seven patients who completed treatment improved on the RMI. One of these patients had a relapse within two months after the last cycle and six patients were in remission six months after the last dexamethasone cycle. Pulsed high dose dexamethasone induced remissions ranged from at least 15 to 23 months. This treatment needs to be tested against standard treatment in a randomised study.