Physician Reported Reasons for Cidp Treatment Choice across 5 European Countries: Results from a Real-World Survey

OBJECTIVES: Chronic inflammatory demyelinating polyneuropathy (CIDP) is a rare, chronic, neurological condition characterized by progressive muscle weakness and impaired sensory function. Treatments include intravenous/subcutaneous immunoglobulin (IVIg/SCIg), corticosteroids (CS), non-steroidal immunosuppressive therapies (NSISTs), or biologics; plasma exchange (PLEX) may be recommended in some cases.

METHODS: The Adelphi CIDP Disease Specific Programme™ is a cross-sectional survey of physicians and their CIDP patients from France, Germany, Italy, Spain, UK (September 2022 - April 2023). Physicians reported on patient demographics, current and previous treatment, and reasons for treatment choice (5 categories: symptom control, administration, safety, access/cost, and general efficacy). Treatment use and reasons for treatment choice were reported by drug class and by line of therapy (1^st, 2^nd, 3^rd or later).

RESULTS: Eighty-three physicians provided treatment data for 436 CIDP patients. Mean patient age was 53.6 (SD±12.3) years, 62.5% were male, and mean time since diagnosis was 47.4 (SD±50.1) months.

Across lines of therapy, IVIg/SCIg/PLEX was most frequently prescribed (54.9%), followed by CS (45.1%), and NSISTs 16.0%); biologics (40% 3^rd line/later) were reserved for later lines.

General efficacy (93.7%), symptom control (78.2%) and safety (64.6%) were the three most frequent reasons for the physician’s treatment choice across all drug classes. Mode of administration and access/cost were more frequently selected as reasons for NSIST use than for other drug classes (55.4% and 44.6% respectively). Symptom control was more frequent for 2^nd (84.3%) and 3^rd line (83.3%) than for 1^st line therapy (74.7%). Safety was more frequent for 3^rd line/later (76.7%) than for 1^st/2^nd line therapies (65%).

CONCLUSIONS: IVIG/SCIG/PLEX therapies are the most common CIDP treatments across lines of therapy. General efficacy, symptom control and safety are the most frequent reasons for treatment choice, however physician priorities may differ by line of therapy. These findings highlight limitations with available therapies and potential need for new treatment options.