What Achieving an INCAT Score of 0 or 1 Means for Patients With CIDP

For clinicians treating chronic inflammatory demyelinating polyneuropathy, numerical improvements on disability scales ultimately matter only if they translate into better function for patients. As therapies become more effective, the focus has increasingly shifted from simply preventing worsening to understanding what meaningful recovery looks like in everyday life.

In this NeurologyLive® Special Report, Karissa Gable, MD, FAAN, professor of neurology at Duke University, and Jeffrey Allen, MD, associate professor of neurology at the University of Minnesota, continue their discussion of the ADHERE and ADHERE+ post hoc analysis evaluating subcutaneous efgartigimod PH20 (Vyvgart Hytrulo). Drawing on the study findings and their own clinical experience, the two experts explore how lower disability scores can help frame treatment expectations for both physicians and patients.

In this episode, the conversation centers on one of the study's most notable findings: the proportion of patients who achieved an INCAT score of 0 or 1 after treatment with efgartigimod. Gable and Allen explain why these outcomes extend beyond trial statistics, discussing how minimal disability can translate into greater independence, improved daily function, and a more patient-centered understanding of treatment success.

Karissa Gable, MD, FAAN:

When I look at these data, I think about where patients started. The mean baseline INCAT score was 4.6, and no patients had an INCAT score of 1 or lower at baseline. Looking at how those scores changed over time, what stands out to me is that patients who responded to this targeted therapy continued to demonstrate meaningful improvement. That's my interpretation of these findings. Jeff, I don't know if you have any additional thoughts.

Jeffrey Allen, MD:

My takeaway is very similar. These were patients who were really struggling before entering the study, and many of them ultimately reached an INCAT score of 0 or 1, meaning they had minimal or even no disability related to their CIDP.

That is one of our primary treatment goals. We want patients to be as close to normal functioning as possible. We certainly can't achieve that for every patient, but it's encouraging to know that, at least for some individuals with CIDP, that level of improvement is possible.