May 29, 2019 at 6:21 pm
It is extremely difficult to comment on a treatment plan when one has not seen and examined the individual patient. Furthermore, there is not a universal consensus on how to treat CIDP. Steroids, such as prednisone, IVIg and plasma exchange have all been proven to be of benefit but there are disagreements are about the best way to administer them. If steroids are used, the most common strategy is to use them daily at a starting dose somewhere between 50 and 100 mg. Many neurologists combine that with azathioprine because there are many side effects of long term steroids and they believe that azathioprine enables them to reduce the steroid dose more quickly but the evidence to support that is not good. So, I can say that your treatment plan is not completely out of line with what is commonly used. However, I am concerned that your strength is continuing to decline which is of concern regardless of what treatment or regimen is used. It is still early; you have been on treatment for only 4 weeks, but if the decline in strength continues you should try to get an earlier appointment with your neurologist to see whether a different approach is justified. That could mean a higher dose of daily steroids, a much higher dose of pulsed (i.e., once a week) steroids or a switch to IVIg.