Short-term treatment of CIDP with efgartigimod: a case series in China
Chong Sun, Jianian Hu, Yanyin Zhao, Yongsheng Zheng, Quanhua Meng, Sushan Luo, Kai Qiao, Jian Sun, Jiahong Lu, Jie Lin, Chongbo Zhao
Abstract
Objective Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a type of autoimmune neuropathy with treatment challenges due to the limitations of standard of care therapies. Efgartigimod, a neonatal Fc receptor antagonist, has shown potential in treating antibody-mediated disorders including CIDP (ADHERE study), but real-world studies on the application of efgartigimod in CIDP are still lacking. This study aimed to evaluate the short-term efficacy and safety of efgartigimod in five patients with CIDP in China. Methods Clinical effectiveness was assessed using the Inflammatory Neuropathy Cause and Treatment (INCAT) disability scale, Inflammatory Rasch-built Overall Disability Scale (IRODS), Medical Research Council (MRC) sum score (0–60), grip strength, Neuropathy Impairment Score (NIS), and 3-m Time Up and Go Test (TUG). Safety was evaluated by monitoring adverse events and measuring white blood cell count, serum albumin concentration, and plasma IgG concentration. Peripheral CD4 + T and CD19 + B lymphocytes were measured before and after efgartigimod treatment. Results All five (100%) patients responded to efgartigimod treatment, with four (80%) meeting predefined effectiveness criteria within 8 weeks. The average reduction rate in total IgG was 43%. Adverse events were minimal, with one patient experiencing transient diarrhea, and no aggravation of pre-existing conditions was noted. Interpretation Efgartigimod demonstrates promising efficacy and safety for short-term treatment of CIDP, offering a potential alternative therapy. This study provides valuable evidence from the real-world application of efgartigimod in CIDP, and the results indicate further research is warranted.