ArticleNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2024
Eculizumab for myasthenic exacerbation during treatment with immune-checkpoint inhibitors.
Article in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
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Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 11 citations in OpenAlex.
- Triple-M syndrome after immune checkpoint inhibitors: a systematic review of cases-early recognition is critical to survival.Frontiers in neurology · 2026Pooled it
- Successful rescue therapy with eculizumab for probable tislelizumab-related MMM overlap syndrome with dual positivity for anti-acetylcholine receptor and anti-titin antibodies: a case report and literature review.Frontiers in immunology · 2026Pooled it
- Italian recommendations for the diagnosis and treatment of myasthenia gravis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Article
- Efgartigimod in the treatment of immune checkpoint inhibitor-related myasthenia gravis -myositis overlap syndrome: a case report.Frontiers in immunology · 2026Article
- Innate Immunity in the Pathogenesis of Selected Autoimmune Neurological Diseases.Journal of clinical medicine · 2025Review
- Neuromuscular complications associated with cancer immunotherapy.Journal of the National Cancer Center · 2025Review
- Eculizumab as Treatment in Refractory Impeding and Myasthenic Crisis: A Case Series.Neurocritical care · 2025Article
- Therapeutic strategies targeting complement in myasthenia gravis patients.Journal of neurology · 2025Review
- Pembrolizumab-induced myocarditis, myositis, and myasthenia gravis overlap syndrome (IM3OS) treated with Efgartigimod: case report.Immunotherapy · 2025Article
- Eculizumab as rescue therapy for relapse of myasthenia gravis after immune-checkpoint inhibitors: a case report.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Article
- Eculizumab as fast-acting rescue therapy for pembrolizumab-induced impending crisis state of myasthenia gravis: a case report.Therapeutic advances in neurological disorders · 2025Article
- Thymus Surgery Prospectives and Perspectives in Myasthenia Gravis.Journal of personalized medicine · 2024Review
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Authors and funding
11 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo test the complement inhibitor eculizumab in the treatment of MG exacerbation during therapy with the immune-checkpoint inhibitor (ICI) pembrolizumab, avoiding its discontinuation, which could be detrimental to oncologic course.
methodsA 76-year-old male with non-thymomatous generalized anti-AchR + MG (MGFA class IVB), during treatment with pembrolizumab for colorectal cancer, developed a severe myasthenic exacerbation, refractory to steroids and IvIg. Eculizumab was started, without pembrolizumab discontinuation. The patient was prospectively followed using MGFA, MG Activities of Daily Living (MG-ADL), Quantitative MG (QMG), MG Composite (MGC), and MG Quality of Life 15 (MG-QOL-15).
resultsAfter an 18-week follow-up, the patient presented a progressive improvement in scores on all scales, achieving a MGFA class IIIB. The percentage improvement was 40% in MG-ADL, 36% in MG Composite, and about 30% in QMG. Bulbar symptoms improved by about 70% in MG-ADL and MG Composite and 40% in QMG. Eculizumab was well tolerated and pembrolizumab regularly continued, with a good control of cancer progression. DISCUSSION: Eculizumab potentially offers a mechanism-based treatment of MG in patients under anti-programmed cell death protein 1 (PD-1) agents, without interfering with their mechanism of action and avoiding their discontinuation. Larger case series deserve to be evaluated.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.