To report expert insight on transitioning patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) from intravenous immunoglobulin (IVIg) to subcutaneous (SC) efgartigimod PH20 (co-formulated with recombinant human hyaluronidase PH20).
Real-world data on transitioning patients with CIDP from IVIg to efgartigimod PH20 SC are limited.
We summarize key insights and observations from 2 virtual interview-style group discussions (sponsored by argenx) held in April 2025 with 5 treating US health care providers with experience transitioning over 90 patients from IVIg to efgartigimod PH20 SC. Topics discussed included appropriate patient types, ideal approaches for transitioning, monitoring strategy, and outcome measures.
Patients considered suitable for transitioning included those experiencing treatment dissatisfaction or lack of efficacy, IVIg safety/tolerability concerns, poor venous access, adherence challenges, or patient preference. Decisions were made through conversation and expectation setting with patients. Of the 225 patients under care by these providers, 91 (40.4%) were deemed eligible for switch. For these providers, efgartigimod PH20 SC is ideally initiated 2–4 weeks after the final IVIg dose. Bridging therapies were not considered necessary. Patients were reassessed every 4–6 weeks following initial switch to efgartigimod PH20 SC to monitor tolerability; time between visits increased as CIDP symptoms stabilized or improved. The course of treatment for patients may require adjustments based on their response to therapy or individual factors (eg, perceived changes, underlying illness, infection). Transitions were considered successful when tolerability and clinical stability or improvement of disease was measurable by 3–6 months after switching to efgartigimod PH20 SC. Overall, 78/91 (85.7%) patients successfully switched from IVIg to efgartigimod PH20 SC; 13 (14.3%) attempted the switch but discontinued treatment.
Successful transition from IVIg to efgartigimod PH20 SC can be achieved with attention to clinical considerations, expectation setting, and appropriate monitoring. Early adjustments to treatment may be necessary to support positive patient outcomes.