A study to test the effects and safety of riliprubart in people with chronic inflammatory demyelinating polyneuropathy (CIDP) for which the usual treatments do not work

Prior treatment

• Use of any specific complement system inhibitor (eg, eculizumab) within 12 weeks or 5 times the half life of the product, whichever is longer.
• Treatment within 6 months prior to dosing with immunosuppressive/ chemotherapeutic medications, such as cyclophosphamide, methotrexate, tacrolimus, interferon, or tumor necrosis factor (TNF)-α inhibitors. Certain immunosuppressants commonly used in CIDP (azathioprine, cyclosporine, or mycophenolate mofetil) are allowed, as indicated under inclusion criterion.
• Any vaccination received within 28 days prior to dosing (with few exceptions to be confirmed at screening)
• Participation in another clinical trial with an investigational drug or receipt of an investigational product within 12 weeks or 5 times the half-life of the product, whichever is longer, prior to Screening
• Positive result of any of the following tests: --Hepatitis B surface antigen (HBsAg) --Anti-hepatitis B core antibodies (anti-HBc Ab) (unless anti-hepatitis B surface antibodies [anti-HBs Ab] are also positive, indicating natural immunity) --Anti hepatitis C virus (anti HCV) antibodies (participants with positive hepatitis C antibody due to prior resolved disease can be enrolled, only if a confirmatory negative Hepatitis RNA test is obtained). --Anti-human immunodeficiency virus 1 and 2 (anti-HIV1 and anti-HIV2) antibodies
• Evidence of CIDP worsening within the 6 weeks following a prior vaccination that, in the opinion of the Investigator, constituted a relapse
• Serious infections requiring hospitalization within 30 days prior to Screening and any active infection requiring antimicrobial treatment during screening or presence of a condition that may predispose the participant to increased risk of infection (eg, medical history such as known immunodeficiency or history of recurrent infections)
• Clinical diagnosis of Systemic Lupus Erythematosus (SLE) or family history of SLE. For a participant with an antinuclear antibody (ANA) titer ≥1:160 and a positive anti-double-stranded DNA (anti-dsDNA) at Screening, SLE diagnosis must be ruled out prior to enrollment.
• Any other clinically meaningful medical history or ongoing medical condition (as determined by the Investigator at Screening) that might impact benefit-risk assessment, jeopardize the safety of the participant, or compromise the quality of the data collected in this study; or history or presence of other significant concomitant illness that would adversely affect participation in this study, per Investigator’s judgment.
• Documented history of attempted suicide over the 6 months prior to the Screening visit, presence of suicidal ideation of category 4 or 5 on C-SSRS during screening, OR if in the Investigator’s judgment, the participant is at risk for a suicide attempt.
• Recent or planned major surgery that could confound the results of the trial or put the participant at undue risk
• Participant has recently received immunoglobulins (IVIg or SCIg).
• Recent treatment with plasma exchange.
• Prior treatment with riliprubart
• Prior treatment with (any time) with highly immunosuppressive/chemotherapeutic medications with sustained effects, eg, mitoxantrone, alemtuzumab, cladribine
• Prior treatment (any time) with total lymphoid irradiation or bone marrow transplantation
• -Prior treatment with B cell depleting agents such as rituximab within 6 months.

Other illness

• Polyneuropathy of other causes, including but not limited to: acute demyelinating polyneuropathies (eg, Guillain-Barré syndrome), hereditary demyelinating neuropathies, neuropathies secondary to infection or systemic disease, diabetic neuropathy, drug- or toxin-induced neuropathies, multifocal motor neuropathy, polyneuropathy related to Immunoglobulin M (IgM) monoclonal gammopathy, POEMS syndrome, and lumbosacral radiculoplexus neuropathy.
• Participant not suitable for participation, whatever the reason, as judged by the Investigator, including medical or clinical conditions, or potential risk for noncompliance to study procedures
• Any other neurological or systemic disease that can cause symptoms and signs interfering with treatment or outcome assessments
• Poorly controlled diabetes
• Sensitivity to any of the study interventions, or components thereof, or drug or other allergy that, in the opinion of the Investigator, contraindicates participation in the study. Specifically, history of any hypersensitivity reaction to riliprubart or its components or of a severe allergic or anaphylactic reaction to any humanized or murine monoclonal antibody.

Lab values

• Any screening laboratory values outside normal limits or abnormal ECG considered in the Investigator’s judgment to be clinically significant in the context of this trial.
• Pregnancy, defined as a positive result of a highly sensitive urine or serum pregnancy test, or lactation

Other

• Sensory CIDP, Distal CIDP and focal CIDP variants.
• Accommodation in an institution because of regulatory or legal order; eg, imprisoned or legally institutionalized
• Participants are employees at the clinical study site or other individuals directly involved in the conduct of the study, or immediate family member of such individuals
• Any country related specific regulation that would prevent the participant from entering the study
• Recent ttreatment with efgartigimod.

• Participant must have CIDP or possible CIDP criteria, based on European Academy of Neurology (EAN)/ Peripheral Nerve Society (PNS) Task Force CIDP guidelines, second revision (2021).
• Participant must have documented vaccinations against encapsulated bacterial pathogens given within 5 years prior to Day 1 or initiated a minimum of 14 days prior to first dose of study intervention
• Contraception for sexually active male or female participants; not pregnant or breastfeeding; no sperm donating for male participant.
• A body weight at Screening of 35 kg to 154 kg (77 to 340 lbs), inclusive
• Participant must have either typical CIDP, or one of the following two CIDP variants: motor CIDP, multifocal CIDP (also known as Lewis Sumner Syndrome). Diagnosis must be confirmed by the adjudication committee.
• Participant must be refractory to either immunoglobulin therapy or corticosteroid therapy, as defined below.--Immunoglobulin-refractory subgroup: Historic evidence of failure or inadequate response to immunoglobulin therapy prior to screening, --Corticosteroid-refractory subgroup: Historic evidence of failure or inadequate response to corticosteroid therapy prior to screening,
• Participant has an INCAT score of 2 to 9
• Any allowed immunosuppressant drugs (azathioprine, cyclosporine, or mycophenolate mofetil) have been taken for ≥6 months.
• Participant may be receiving low-dose oral corticosteroids (≤20 mg/day of prednisone or equivalent)
• Participant must have active disease, defined by a CIDP disease activity score (CDAS) of ≥ 2 points at Screening