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J Clin Neurol.  2026 Jan;22(1):76-88. 10.3988/jcn.2025.0247.

Efficacy, Safety, and Tolerability of Subcutaneous Efgartigimod PH20 in Chinese Patients With Chronic Inflammatory Demyelinating Polyneuropathy: A Prespecified Subpopulation Analysis of the Multicentre, Randomised-Withdrawal, Double-Blind, Placebo-Controlled, Phase II ADHERE Trial

Affiliations
  • 1Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
  • 2Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China
  • 3Department of Neurology, Qilu Hospital of Shandong University, Jinan, China
  • 4Department of Neurology, Tangdu Hospital, The Fourth Military Medical University, Xi’an, China
  • 5Department of Neurology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
  • 6Department of Neurology, Xuanwu Hospital Capital Medical University, Beijing, China
  • 7Department of Neurology, Sichuan Provincial People’s Hospital, Chengdu, China
  • 8Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China
  • 9Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, China
  • 10Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China
  • 11Department of Neurology, Xiangya Hospital of Central South University, Changsha, China
  • 12Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
  • 13Department of Neurology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
  • 14Department of Neurology, Zhejiang Provincial People’s Hospital, Hangzhou, China
  • 15Department of Neurology, Yan’an University Xianyang Hospital, Xianyang, China
  • 16Department of Neurology, The Affiliated Hospital of Guizhou Medical University, Guiyang, China
  • 17Department of Neurology, Affiliated Hospital of Jining Medical University, Jining, China
  • 18Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai, China
  • 19Department of Neurology, First Hospital of Shanxi Medical University, Taiyuan, China
  • 20Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
  • 21Department of Neurology, Chifeng Municipal Hospital, Chifeng, China
  • 22Zai Lab (Shanghai) Co., Ltd, Shanghai, China
  • 23argenx, Tokyo, Japan
  • 24argenx, Ghent, Belgium

Abstract

Background and Purpose
Efgartigimod, a neonatal Fc receptor inhibitor, reduces IgG recycling and thus decreases pathogenic IgG autoantibody levels. This subpopulation analysis aimed to assess the efficacy, safety, and tolerability of subcutaneous efgartigimod PH20 in Chinese participants with chronic inflammatory demyelinating polyneuropathy (CIDP).
Methods
ADHERE was a multistage, randomised-withdrawal, placebo-controlled phase II trial in adult participants with active CIDP. Eligible participants received open-label treatment with efgartigimod weekly for ≤12 weeks (Stage A) and those with confirmed evidence of clinical improvement (ECI) were randomised to receive double-blind treatment with efgartigimod or placebo weekly for ≤48 weeks (Stage B). Primary endpoints were proportion of participants with confirmed ECI (Stage A) and time to clinical deterioration as measured by adjusted Inflammatory Neuropathy Cause and Treatment score (Stage B). This descriptive analysis reports the results from the Chinese subpopulation.
Results
ADHERE enrolled 58 participants from mainland China for Stage A and of those, 47 were randomised (21 efgartigimod, 26 placebo) for Stage B. In Stage A, 45 (77.6%; 95% con-fidence interval [CI], 64.7%–87.5%) participants achieved confirmed ECI. In Stage B, median time to clinical deterioration was not reached with efgartigimod vs. 113.0 days (95% CI, 43.0– 181.0 days) with placebo (hazard ratio, 0.313; 95% CI, 0.109–0.905). Across stages, most adverse events were mild or moderate, and no death occurred. No adverse events led to treatment discontinuation.
Conclusions
Subcutaneous efgartigimod PH20 demonstrated clinical response and lowered the risk of clinical deterioration compared to placebo in Chinese participants with CIDP, while maintaining favourable safety and tolerability profiles.

Keyword

chronic inflammatory demyelinating polyneuropathy; efgartigimod; neonatal Fc receptor inhibitor
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