MATCHING-ADJUSTED INDIRECT COMPARISON OF SUBCUTANEOUS IMMUNOGLOBULIN IGPRO20 AND EFGARTIGIMOD IN PATIENTS WITH CHRONIC INFLAMMATORY DEMYELINATING POLYNEUROPATHY
Author(s)
Batyrkhan Kuatov, MA1, Paul Spin, PhD2, Muhaimen Siddiqui, MHS2, Sarah Organ, PhD2, Laurence UNDREINER, MSc3, Yinglei Li, PhD4.
1Director HEOR, Global Market Access, CSL Behring, Bern, Switzerland, 2EVERSANA, Victoria, BC, Canada, 3CSL Behring, Paris, France, 4CSL Behring, King of Prussia, PA, USA.
1Director HEOR, Global Market Access, CSL Behring, Bern, Switzerland, 2EVERSANA, Victoria, BC, Canada, 3CSL Behring, Paris, France, 4CSL Behring, King of Prussia, PA, USA.
OBJECTIVES: No head-to-head trials have compared subcutaneous immunoglobulin IgPro20 with efgartigimod, a subcutaneous neonatal Fc receptor inhibitor, in the maintenance treatment of chronic inflammatory demyelinating polyneuropathy (CIDP). An anchored matching-adjusted indirect comparison (MAIC) was conducted to assess their relative effectiveness.
METHODS: Individual patient data from PATH (IgPro20 0.4 g/kg and placebo [PBO]) and published data from ADHERE (efgartigimod 1,000 mg and PBO) were used in the MAIC. The outcome was the number of patients with a CIDP relapse, defined as an increase in adjusted Inflammatory Neuropathy Cause and Treatment (aINCAT) ≥1 from maintenance baseline. The outcome was analyzed using a Poisson model with an offset to account for follow-up time differences between trials. Relative effectiveness was estimated from unweighted and weighted models, with MAIC weights applied to balance populations on key treatment effect modifiers (CIDP duration, aINCAT score, age, and grip strength at maintenance baseline). Comparisons were performed for PATH versus: (1) the full ADHERE population (naïve and pre-treated patients); and (2) a pre-treated subgroup (patients with prior corticosteroid or immunoglobulin exposure and CIDP Disease Activity Status ≥4 at screening). Results were summarized as relapse rate ratios (RR) and 95% confidence intervals (CI).
RESULTS: In the unadjusted analyses, point estimates favoured IgPro20 vs efgartigimod in both the full ADHERE (RR: 0.59 [95% CI: 0.31, 1.14]) and pre-treated (RR: 0.73 [95% CI: 0.36, 1.49]) populations. After adjustment, point estimates favoured IgPro20 versus efgartigimod in the ADHERE full population (RR: 0.76 [95% CI: 0.33, 1.75]), while showing no differences in the pre-treated population (RR: 1.01 [95% CI: 0.42, 2.46]). No comparisons were statistically significant.
CONCLUSIONS: MAIC results suggest similar effectiveness between IgPro20 and efgartigimod for CIDP maintenance, with point estimates numerically favouring IgPro20 when compared with the full ADHERE population. Findings should be interpreted with caution due to MAIC limitations and uncertainty.
METHODS: Individual patient data from PATH (IgPro20 0.4 g/kg and placebo [PBO]) and published data from ADHERE (efgartigimod 1,000 mg and PBO) were used in the MAIC. The outcome was the number of patients with a CIDP relapse, defined as an increase in adjusted Inflammatory Neuropathy Cause and Treatment (aINCAT) ≥1 from maintenance baseline. The outcome was analyzed using a Poisson model with an offset to account for follow-up time differences between trials. Relative effectiveness was estimated from unweighted and weighted models, with MAIC weights applied to balance populations on key treatment effect modifiers (CIDP duration, aINCAT score, age, and grip strength at maintenance baseline). Comparisons were performed for PATH versus: (1) the full ADHERE population (naïve and pre-treated patients); and (2) a pre-treated subgroup (patients with prior corticosteroid or immunoglobulin exposure and CIDP Disease Activity Status ≥4 at screening). Results were summarized as relapse rate ratios (RR) and 95% confidence intervals (CI).
RESULTS: In the unadjusted analyses, point estimates favoured IgPro20 vs efgartigimod in both the full ADHERE (RR: 0.59 [95% CI: 0.31, 1.14]) and pre-treated (RR: 0.73 [95% CI: 0.36, 1.49]) populations. After adjustment, point estimates favoured IgPro20 versus efgartigimod in the ADHERE full population (RR: 0.76 [95% CI: 0.33, 1.75]), while showing no differences in the pre-treated population (RR: 1.01 [95% CI: 0.42, 2.46]). No comparisons were statistically significant.
CONCLUSIONS: MAIC results suggest similar effectiveness between IgPro20 and efgartigimod for CIDP maintenance, with point estimates numerically favouring IgPro20 when compared with the full ADHERE population. Findings should be interpreted with caution due to MAIC limitations and uncertainty.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
CO33
Topic
Clinical Outcomes, Study Approaches
Topic Subcategory
Comparative Effectiveness or Efficacy
Disease
Rare & Orphan Diseases