{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T14:03:09Z","timestamp":1789394589636,"version":"build-2803163510"},"reference-count":61,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) management is undergoing a paradigm shift with the emergence of targeted biologicals. We aimed to compare the efficacy, safety, and functional outcomes of neonatal Fc receptor (FcRn) inhibitors against conventional immunotherapies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a systematic review and frequentist network meta-analysis (NMA) of randomized controlled trials (RCTs) indexed in PubMed\/MEDLINE, Embase, CENTRAL, Web of Science, ClinicalTrials.gov, and WHO ICTRP from database inception to February 2026. Interventions included FcRn inhibitors (efgartigimod alfa, rozanolixizumab), intravenous\/subcutaneous immunoglobulin (IVIg\/SCIG), corticosteroids, plasma exchange (PLEX), and rituximab. The primary outcome was clinical response rate. Secondary outcomes included serious adverse events (SAEs), discontinuation due to adverse events (DCAE), and grip-strength change as a distal motor outcome. Treatments were ranked using P-scores, and certainty of evidence was summarized using CINeMA\/GRADE domains.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Eighteen RCTs (n=2,184) were included. In the primary efficacy network (I2\u00a0=\u00a00.37%), PLEX (OR 33.60, 95% CI 3.15\u2013358.90; P-score 0.9415) and corticosteroids (OR 15.44, 95% CI 3.53\u201367.47; P-score 0.9056) demonstrated the highest probability of achieving clinical response. Efgartigimod alfa showed significant clinical response (OR 3.14, 95% CI 1.34\u20137.33) and ranked highest for grip-strength change (SMD 0.67, 95% CI 0.09\u20131.24; P-score 0.8847), although this analysis was based on five studies and should be interpreted as a distal motor outcome rather than a comprehensive functional endpoint. For secondary outcomes, FcRn inhibitors had SAE estimates comparable to placebo (efgartigimod OR 1.00, 95% CI 0.31\u20133.20; rozanolixizumab OR 0.94, 95% CI 0.05\u201316.37), and rozanolixizumab ranked highest for DCAE\/acceptability (P-score 0.7896). Heterogeneity was low to modest across secondary networks (SAEs I2\u00a0=\u00a012.40%; DCAE I2\u00a0=\u00a00.00%; grip strength I2\u00a0=\u00a024.10%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>PLEX and corticosteroids showed the strongest relative effects for short-term clinical response, whereas efgartigimod alfa showed a significant treatment effect and the highest ranking for grip-strength change among studies reporting this distal motor measure. IVIg remains a broadly supported comparator across induction and maintenance settings. These findings should inform, but not replace, individualized clinical decision-making because patient-level treatment-effect modification, biomarker status, prior treatment response, and long-term neurophysiological outcomes were not directly evaluated.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1856507","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T13:09:23Z","timestamp":1789391363000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative efficacy, safety, and functional recovery of neonatal fc receptor inhibitors and conventional immunotherapies for chronic inflammatory demyelinating polyradiculoneuropathy: a systematic review and network meta-analysis"],"prefix":"10.3389","volume":"17","author":[{"given":"Qingqing","family":"Jiang","sequence":"first","affiliation":[{"name":"First People\u2019s Hospital of Changzhou","place":["Changzhou, 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