Chronic inflammatory demyelinating polyneuropathy (CIDP) is a rare, immune-mediated peripheral nerve disease that presents significant challenges in both diagnosis and long-term care. In her recent i3 Health activity, Karissa Gable, MD, Professor of Neurology at Duke University Medical Center, discussed strategies for improved detection and individualized management of CIDP. In this follow-up discussion, she joins us again to share updates in the field that have occurred since the launch of the activity—including an international consensus definitions paper that establishes standardized terminology for concepts such as remission, refractory disease, treatment response, and stability—as well as the continued importance of shared decision making throughout the patient journey.

Standardizing the Language of CIDP

Dr. Gable described the consensus paper as a significant update in standardizing the language and definitions used in CIDP. Convening through an international collaboration supported by the Guillain-Barré (GBS)/CIDP Foundation, experts met to establish common definitions for key disease states that previously lacked universal agreement.

"It's so important because when we can come to an agreement, that informs how we categorize patients in clinical trials and how we think about patient care and management going forward," she said.

Now having a shared framework for defining remission, stability, optimal treatment response, and refractory disease, clinicians and researchers will be better equipped to compare study results, design future trials, and make more informed treatment decisions for individual patients.

A Growing Pipeline of Emerging Therapies

Beyond the new consensus definitions, Dr. Gable also discussed several investigational therapies that could further expand treatment options for patients with CIDP. She noted that multiple FcRn antagonists remain in clinical development, including nipocalimab and batoclimab, while complement inhibitors continue to be evaluated in several ongoing studies.

Although one complement inhibitor trial was discontinued because of futility, Dr. Gable remains optimistic about the broader research landscape. "Hopefully we'll have other treatment options and an evolution of the treatment algorithm in the near future," she said. She also emphasized the need for improved serologic biomarkers that could strengthen diagnosis and help guide long-term disease management.

Shared Decision Making Remains Central

As the therapeutic landscape evolves, Dr. Gable stressed that selecting the optimal treatment extends beyond efficacy alone. Instead, clinicians should consider each patient's lifestyle, comorbidities, treatment preferences, and willingness to use different routes of administration.

"We take all that information together and make a mutual decision to figure out what the best option is for patients," she explained.

Although current first-line therapies are effective for many patients, she acknowledged that some individuals require alternative approaches, making personalized care and ongoing reassessment essential components of successful management.

Building Confidence in CIDP Care

Dr. Gable encouraged clinicians to view the educational activity as a comprehensive resource covering the full spectrum of CIDP management—from diagnosis using the 2021 European Academy of Neurology/Peripheral Nerve Society (EAN/PNS) guidelines to current treatment algorithms and emerging therapies.

"I think this is a really comprehensive activity," she said. "It's great to take some time to complete it and understand CIDP better."

As new definitions, biomarkers, and therapies continue to emerge, Dr. Gable believes the field is steadily moving toward more standardized and individualized care for patients living with CIDP.

Key Takeaways

A new international consensus paper has established standardized definitions for remission, refractory disease, stability, and treatment response in CIDP.
Common definitions will improve clinical trial design while supporting more consistent patient management.
Several FcRn antagonists and complement inhibitors remain in development, with additional treatment options expected in the coming years.
Research into serologic biomarkers may further improve diagnosis and individualized management.
Shared decision making that incorporates patient preferences, lifestyle, and treatment goals remains fundamental to optimal CIDP care.

About the Speaker

Karissa Gable, MD, is a Professor of Neurology at Duke University Medical Center in Durham, North Carolina. She specializes in the treatment of chronic inflammatory demyelinating polyneuropathy (CIDP), amyloid polyneuropathy, hereditary neuropathy, and peripheral neuropathy. Dr. Gable is actively involved in clinical trials as well as education training for medical students, residents, and fellows. She has authored or coauthored numerous publications in peer-reviewed journals.

Additional Advances in CIDP Research and Clinical Trials