Reply To: Prednisolone making CIDP much worse….?

Rickd: I stopped IvIg when I was given plasmapheresis. The two treatments cannot be done together, because they conflict. Plasma exchange removes what the IvIg puts in. We switched to PE because the IvIg wasn’t giving the desired result and I continued getting much weaker. That was in late 2010 and I have had no IvIg since.

I had nine PE treatments over a three week period, approximately every other day. Since then, my treatment has been drugs — prednisone and mycophenolate mofetil, the prednisone only for a year.

IvIg and PE are considered to of comparable effectiveness, but that is statistical. For an individual case, one may be better than the other. In my case, I continued getting weaker after two five-day loading doses, then crashed when I got a lung infection. PE was the only treatment left for such an extreme case. Since then, I have steadily improved with no signs of relapse, however it is not possible to say how I would have fared with different treatment. It’s speculative, because there is so much variation case-to-case. My feeling is that PE was the right treatment for me, and that the large number of treatments was a factor in my good recovery (five treatments is typical), but I can’t prove it. All I know for sure is that I am happy with how it has turned out so far.

I wish you good luck with your PE and hope you can receive enough treatments to do the trick. Will this be an outpatient procedure? I am not familiar with that. Mine were in-hospital with a large catheter installed for the purpose. Keep in mind that even if your CIDP is arrested, evidenced by increasing strength where you have weakness, it will still take some time to get past the chronic fatigue stage.