Transcript
Determining appropriate initial treatment in CIDP
Eduardo Nobile-Orazio (University of Milan, Italy) provides guidance on how to select the most appropriate initial treatment following a CIDP diagnosis. View transcript.
Eduardo Nobile-Orazio, MD, PhD
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I would say what we usually prefer to do if we have a young patient, or a patient with a recent onset, we personally, we prefer to start with immunoglobulin because they're better tolerate and we can treat the patient on day service. And, but of course, you know, that cannot be a general rule because as I mentioned before, an immunoglobulin is a much more expensive than steroids. Of course, in Italy, the cost of one year of steroids will not reach 1,000 euro.
If you talk about immunoglobulin, we are talking about 40 to 50,000, at least 40 to 50,000 euros. So that is something, you know, you have to consider. And also it depends if you, in Italy we have a social system, you know,? The hospital, the social system pay. In other country might not be that condition. So if you do not have an insurance, so you have to consider this point. But from a clinical point of view, we prefer to use immunoglobulin. Of course, immunoglobulin at the beginning of the patient has to come to the clinic. And if you use steroids. Steroids, it take longer to you to work. So if the patient has a recent disease, you know, they may have to wait three to four months before improving. With immunoglobulin the improvement faster. And so also you stop the progression of the disease from the beginning, but it's more expensive.
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