Selective Complement Modulation and the Future of CIDP Therapy

Targeting the complement system has become one of the most promising frontiers in autoimmune neurology. Within chronic inflammatory demyelinating polyneuropathy (CIDP), growing evidence supports the idea that complement-mediated inflammation contributes to nerve injury and disease progression. Earlier generations of complement inhibitors offered broad immunosuppressive effects but also raised concerns about increased susceptibility to infection. More selective agents, such as C1s inhibitors, are designed to interrupt autoimmune pathways while leaving key host-defense mechanisms intact—a potential step forward in balancing efficacy with immune preservation.

In this final episode of Advancing CIDP Care, Amit Sachdev, MD, provides an overview of riliprubart, a C1s inhibitor under investigation for CIDP. He explains how the therapy aims to selectively modulate the classical complement pathway and details the design of its dual clinical program, which includes both IVIg-refractory and IVIg-maintained patient cohorts. Dr. Sachdev highlights how this “add-on” study structure allows patients to remain on trusted therapies while exploring additional benefit, reflecting a broader trend toward precision modulation rather than total immune suppression in CIDP care.