Cladribine treatment in chronic inflammatory demyelinating polyradiculoneuropathy and multifocal motor neuropathy: two case reports.

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and multifocal motor neuropathy (MMN) are immune-mediated peripheral neuropathies that may follow a progressive course and be refractory and poorly tolerated to standard immunomodulatory treatments. Therapeutic options for such patients remain limited. We report two patients with immune-mediated neuropathies-one with typical CIDP and one with MMN-who were treated with low-dose intermittent subcutaneous cladribine. Clinical outcomes were assessed using the Medical Research Council (MRC) sum score and the Inflammatory Neuropathy Cause and Treatment (INCAT) disability score. Both patients demonstrated clinically meaningful and sustained improvements in muscle strength and functional disability lasting up to 24 months after treatment completion. Cladribine was well tolerated; transient lymphopenia occurred in one patient without serious adverse events. These cases suggest that cladribine may represent a potential therapeutic option for selected patients with CIDP or MMN. Further studies are warranted to confirm efficacy and safety.