Exploring the Efficacy and Evidence of Efgartigimod as a Potential Therapy for CIDP: Richard Lewis, MD

WATCH TIME: 3 minutes

“I think as we get more treatments, the question is: what's the role of each treatment and how do you decide which treatment to use? The fact that there were patients who were ‘not taking medicine before,’ whether truly naive or had been off medicine for a while, suggests that there is a potential for this treatment to be a first line treatment. I think understanding that will be important and again, the long-term efficacy rates will be important but there looks to be a very good effect of this.”

Efgartigimod (Vyvgart; Argenx), a human IgG1 antibody Fc fragment, blocks the neonatal Fc receptor (FcRn) and by doing so, recycling of immunoglobulin G (IgG) and pathogenic IgG autoantibody levels are decreased. Researchers think that this mechanism of IgG may have an important role in the pathogenesis of patients with chronic inflammatory demyelinating polyneuropathy (CIDP). Currently, only a limited number of patients with CIDP achieve clinically meaningful benefit from the treatments that are available, which can thus increase long-term safety risks, high costs, and burdensome care.

Recently, findings from the ongoing global phase 2 ADHERE trial (NCT04281472) assessing subcutaneous (SC) efgartigimod PH20 as a treatment for CIDP were presented at the American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM) meeting, held November 1-4, in Phoenix, Arizona, by lead author Richard Lewis, MD, professor of neurology at Cedars-Sinai Medical Center, and colleagues.¹ In the trial, the primary objectives included investigating evidence of clinical improvement (stage A) and efficacy of efgartigimod PH20 SC compared with placebo based on time to occurrence of clinical deterioration (stage B).

At the AANEM Annual Meeting, Lewis sat down in an interview with NeurologyLive® to discuss the presented findings from the trial as well as how the rapid reduction of IgG antibodies in patients with CIDP contributes to the potential effectiveness of FcRn inhibitors. He talked about the considerations that healthcare professionals should keep in mind when discussing the use of this novel treatment with patients who live with CIDP, especially in comparison with the existing available therapies. In addition, Lewis spoke about how the presence of antibodies resistant to traditional treatments might influence the global response rate of FcRn inhibitors in CIDP.

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REFERENCES
1. Lewis R, Allen J, Dysgaard T, et al. Efficacy, Safety, And Tolerability Of Efgartigimod In Patients With Chronic Inflammatory Demyelinating Polyneuropathy: Results From The Adhere Trial. Presented at: American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM) meeting; November 1-4, 2023; Phoenix, AZ. Abstract 143.