Karissa Gable, MD

The neurologist at Duke Health provided insights on how chronic demyelinating inflammatory polyneuropathy treatment is evolving toward biomarker-driven, personalized approaches at the 2025 Carolina Neuromuscular Summit. [WATCH TIME: 2 minutes]

Panelists discuss how physicians can improve outcomes for patients with chronic inflammatory demyelinating polyneuropathy (CIDP) by prioritizing early and accurate diagnosis, personalizing treatment plans, regularly monitoring patients, and addressing the psychological and emotional impact of the disease.

Panelists discuss how addressing the unmet needs in chronic inflammatory demyelinating polyneuropathy (CIDP), such as early diagnosis, personalized treatment options, long-term disease management, and improved access to care, could significantly enhance patient outcomes and quality of life.

Panelists discuss how investigational agents, including the complement inhibitor riliprubart, FcRn inhibitors like nipocalimab, batoclimab, and rozanolixizumab, as well as Bruton tyrosine kinase (BTK) inhibitors and anti–myelin-associated glycoprotein (anti-MAG) antibodies, show promise in providing targeted, personalized treatment options for patients with chronic inflammatory demyelinating polyneuropathy (CIDP) who are refractory to traditional therapies, with ongoing research needed to confirm their efficacy and safety.

Panelists discuss how variable number tandem repeats (VNTR) 3/2 polymorphisms in the FCGRT gene may affect FcRn levels, immunoglobulin G (IgG) half-life, and the effectiveness of intravenous immunoglobulin (IVIg) therapy in chronic inflammatory demyelinating polyneuropathy (CIDP), highlighting early real-world evidence suggesting that genetic testing could help personalize treatment strategies to optimize outcomes for patients based on their specific genotypes.

Panelists discuss how biomarkers, such as neurofilament light chain (NfL), autoantibodies, and inflammatory markers, have potential in enhancing chronic inflammatory demyelinating polyneuropathy (CIDP) diagnosis and treatment monitoring, but emphasize that their use remains experimental, and a comprehensive approach integrating clinical assessments and electrophysiological findings is essential for optimal patient care.

Panelists discuss how treatment options for patients with chronic inflammatory demyelinating polyneuropathy (CIDP) who do not respond to intravenous immunoglobulin (IVIg) or subcutaneous immunoglobulin (SCIg) include second-line therapies such as plasmapheresis, corticosteroids, immunosuppressive agents, and newer options like efgartigimod, with a focus on a tailored approach to manage refractory cases effectively and improve patient outcomes.

Panelists discuss how evaluating the efficacy of treatment in chronic inflammatory demyelinating polyneuropathy (CIDP) involves a combination of clinical, functional, and electrophysiological measures, and emphasize the importance of individualizing treatment approaches based on disease subtype, prior therapy response, comorbidities, patient preferences, and ongoing monitoring to optimize patient outcomes.

Panelists discuss how clinical experience with efgartigimod, a newly FDA-approved treatment for chronic inflammatory demyelinating polyneuropathy (CIDP), demonstrates positive outcomes and a favorable safety profile, while also addressing challenges in transitioning patients from other therapies and emphasizing the importance of proper patient selection and monitoring.

Panelists discuss how a recent study highlights concerns about transitioning patients with chronic inflammatory demyelinating polyneuropathy (CIDP) from intravenous immunoglobulin (IVIg) to efgartigimod, emphasizing the need for a cautious, gradual approach, careful patient selection, and close monitoring to address issues like symptom exacerbation, delayed response, and safety risks.

Panelists discuss how the FDA approval of efgartigimod, based on the positive results from the phase 2 ADHERE trial, provides a new therapeutic option for patients with chronic inflammatory demyelinating polyneuropathy (CIDP), demonstrating significant improvements in disability scores and a manageable safety profile.

Panelists discuss how transitioning stable patients with chronic inflammatory demyelinating polyneuropathy (CIDP) from intravenous immunoglobulin (IVIg) to subcutaneous immunoglobulin (SCIg) can offer greater convenience and independence, with careful consideration of dosing, patient education, and ongoing monitoring to ensure successful treatment outcomes.

Panelists discuss how selecting the appropriate treatment for chronic inflammatory demyelinating polyneuropathy (CIDP) involves considering disease characteristics, patient preferences, and treatment response, with options ranging from intravenous immunoglobulin (IVIg) to emerging therapies based on individual needs and safety considerations.

Panelists discuss how chronic inflammatory demyelinating polyneuropathy (CIDP) can significantly impair quality of life for both patients and caregivers, emphasizing that early recognition and timely treatment are essential to prevent irreversible damage and improve long-term outcomes.

Panelists discuss how a careful, evidence-based approach combining clinical evaluation with electrodiagnostic and supportive findings is critical for accurately diagnosing chronic inflammatory demyelinating polyneuropathy (CIDP) and avoiding common misdiagnoses that can lead to inappropriate treatment.

Panelists discuss how recognizing the diverse clinical presentations and underlying immune mechanisms of chronic inflammatory demyelinating polyneuropathy (CIDP) is essential for accurate diagnosis, differentiating subtypes, and guiding effective, individualized treatment strategies.