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D.1 Efficacy, safety, and tolerability of subcutaneous efgartigimod in chronic inflammatory demyelinating polyneuropathy: results from the ADHERE trial

Published online by Cambridge University Press:  24 May 2024

Z Siddiqi
Affiliation:
(Edmonton)*
JA Allen
Affiliation:
(Minneapolis)
I Basta
Affiliation:
(Belgrade)
C Eggers
Affiliation:
(Linz)
J Guptill
Affiliation:
(Durham)
K Gwathmey
Affiliation:
(Richmond)
C Hewamadduma
Affiliation:
(Sheffield)
E Hofman
Affiliation:
(Ghent)
Y Hussain
Affiliation:
(Austin)
S Kuwabara
Affiliation:
(Chiba)
F Leypoldt
Affiliation:
(Kiel)
J Lin
Affiliation:
(Shanghai)
M Lipowska
Affiliation:
(Warsaw)
M Lowe
Affiliation:
(Ghent)
G Lauria Pinter
Affiliation:
(Milan)
L Querol
Affiliation:
(Barcelona)
N Suresh
Affiliation:
(Tampa)
T Chang
Affiliation:
(Xi’an)
A Tse
Affiliation:
(Ghent)
P Ulrichts
Affiliation:
(Ghent)
PA van Doorn
Affiliation:
(Rotterdam)
B Van Hoorick
Affiliation:
(Ghent)
R Yamasaki
Affiliation:
(Fukuoka)
RA Lewis
Affiliation:
(Los Angeles)
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Abstract

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Background: Efgartigimod, a human immunoglobulin G (IgG)1 antibody Fc fragment, blocks the neonatal Fc receptor, decreasing IgG recycling and reducing pathogenic IgG autoantibody levels. ADHERE assessed the efficacy and safety of efgartigimod PH20 subcutaneous (SC; co-formulated with recombinant human hyaluronidase PH20) in chronic inflammatory demyelinating polyneuropathy (CIDP). Methods: ADHERE enrolled participants with CIDP (treatment naive or on standard treatments withdrawn during run-in period) and consisted of open-label Stage A (efgartigimod PH20 SC once weekly [QW]), and randomized (1:1) Stage B (efgartigimod or placebo QW). Primary outcomes were clinical improvement (assessed with aINCAT, I-RODS, or mean grip strength; Stage A) and time to first aINCAT score deterioration (relapse; Stage B). Secondary outcomes included treatment-emergent adverse events (TEAEs) incidence. Results: 322 participants entered Stage A. 214 (66.5%) were considered responders, randomized, and treated in Stage B. Efgartigimod significantly reduced the risk of relapse (HR: 0.394; 95% CI: 0.25–0.61) versus placebo (p=0.000039). Reduced risk of relapse occurred in participants receiving corticosteroids, intravenous or SC immunoglobulin, or no treatment before study entry. Most TEAEs were mild to moderate; 3 deaths occurred, none related to efgartigimod. Conclusions: Participants treated with efgartigimod PH20 SC maintained a clinical response and remained relapse-free longer than those treated with placebo.

Type
Abstracts
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of Canadian Neurological Sciences Federation