Evidence map›Paper›PMID 38642198›Full record

Trial reportAdvances in therapy2024

Efgartigimod and Ravulizumab for Treating Acetylcholine Receptor Auto-antibody-Positive (AChR-Ab+) Generalized Myasthenia Gravis: Indirect Treatment Comparison.

Cécile van Steen, Lorenzo Celico, Erik Spaepen, Tim Hagenacker, Sven G Meuth, Tobias Ruck, A Gordon Smith, Danielle H Bodicoat, Maria de Francesco, Sergio Iannazzo

Open access · hybridAbstract readComparative StudyRandomized Controlled Trial
In one paragraph

Trial report in Advances in therapy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 2 pooled it
3.7field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 10 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Article
  6. Review
  7. Review
  8. C5 complement inhibition versus FcRn modulation in generalised myasthenia gravis.Journal of neurology, neurosurgery, and psychiatry · 2025
    Observational
  9. New and Emerging Biological Therapies for Myasthenia Gravis: A Focussed Review for Clinical Decision-Making.BioDrugs : clinical immunotherapeutics, biopharmaceuticals and gene therapy · 2025
    Review
  10. Observational
  11. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 3 countries.

Cécile van SteenArgenx BV, 9052, Zwijnaarde (Ghent), Belgium. cvansteen93@gmail.com.ORCID 0000-0002-8872-2678
Lorenzo CelicoHEOR Value Hub, Brussels, Belgium.
Erik SpaepenHEOR Value Hub, Brussels, Belgium.
Tim HagenackerUniversity Medicine Essen, 45147, Essen, Germany.ORCID 0000-0002-3631-3450
Sven G MeuthUniversity Hospital Düsseldorf, 40225, Düsseldorf, Germany.ORCID 0000-0003-2571-3501
Tobias RuckUniversity Hospital Düsseldorf, 40225, Düsseldorf, Germany.ORCID 0000-0001-6332-8650
A Gordon SmithVCU Department of Neurology, Richmond, VA, USA.ORCID 0009-0008-7909-9395
Danielle H BodicoatHEOR Value Hub, Brussels, Belgium.ORCID 0000-0002-2184-4865
Maria de FrancescoHEOR Value Hub, Brussels, Belgium.ORCID 0000-0002-7118-5845
Sergio IannazzoArgenx BV, 9052, Zwijnaarde (Ghent), Belgium.ORCID 0000-0003-3226-5954
Ablynx (Belgium) · BEDüsseldorf University Hospital · DEChildren's Hospital of Richmond at VCU · USEssen University Hospital · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionEfgartigimod and ravulizumab, both approved for treating acetylcholine receptor auto-antibody-positive (AChR-Ab+) generalized myasthenia gravis (gMG), have not been directly compared. This paper assessed comparative effects of efgartigimod vs. ravulizumab for treating adults with AChR-Ab+ gMG using indirect treatment comparison methods.

methodsThe matching-adjusted indirect comparison used data from two randomized trials of adult men and women. The ADAPT (efgartigimod vs. placebo; individual patient data available) population was reweighted to match the CHAMPION (ravulizumab vs. placebo; index study; aggregate data available) population. The relative effect of efgartigimod versus placebo was estimated in this reweighted population and compared with the observed ravulizumab versus placebo effect to estimate the efgartigimod versus ravulizumab effect. The outcomes were Myasthenia Gravis Activities of Daily Living (MG-ADL), Quantitative Myasthenia Gravis (QMG), and Myasthenia Gravis Quality of Life 15-item-revised scale (MG-QoL15r) assessed as cumulative effect (area under the curve; AUC) over 26 weeks (primary) and change from baseline at 4 weeks and time of best response (week 4 for efgartigimod; week 26 for ravulizumab).

resultsFor MG-QoL15r, efgartigimod had a statistically significant improvement compared with ravulizumab over 26 weeks [mean difference (95% confidence interval): - 52.6 (- 103.0, - 2.3)], at week 4 [- 4.0 (- 6.6, - 1.4)], and at time of best response [- 3.9 (- 6.5, - 1.3)]. Efgartigimod had a statistically significant improvement over ravulizumab in MG-ADL at week 4 [- 1.9 (- 3.3, - 0.5)] and at time of best response [- 1.4 (- 2.8, 0.0)] and in QMG at week 4 [- 3.2 (- 5.2, - 1.2)] and at time of best response [- 3.0 (- 5.0, - 1.0)]. For AUC over 26 weeks, improvements were not significantly different between efgartigimod and ravulizumab for MG-ADL [- 8.7 (- 36.1, 18.8)] and QMG [- 13.7 (- 50.3, 22.9)].

conclusionEfgartigimod may provide a faster and greater improvement over 26 weeks in quality of life than ravulizumab in adults with AChR-Ab+ gMG. Efgartigimod showed faster improvements in MG-ADL and QMG than ravulizumab.

Indexed as

Antibodies, Monoclonal, HumanizedMyasthenia GravisReceptors, CholinergicActivities of Daily LivingAdultAgedAutoantibodiesFemaleHumansMaleMiddle AgedQuality of LifeTreatment OutcomeAntibodies, Monoclonal, HumanizedAutoantibodiesReceptors, CholinergicAcetylcholine receptor auto-antibodies positiveAChR-Ab+EfgartigimodGeneralized myasthenia gravisMG-ADLMG-QoL15QMGRavulizumab

Identifiers

PMID38642198
PMCPMC11133097
OpenAlexW4394976172

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.