ArticleNeurology(R) neuroimmunology & neuroinflammation2025
Ravulizumab and Efgartigimod in Myasthenia Gravis: A Real-World Study.
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Article in Neurology(R) neuroimmunology & neuroinflammation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
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21citing papers in PubMed, 2 pooled it
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Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Effectiveness and safety of efgartigimod in myasthenia gravis: A meta-analysis of different antibody subtypes.Immunologic research · 2026Pooled it
- Effectiveness and safety of ravulizumab in anti-acetylcholine receptor antibody-positive (AChR-Ab+) generalized myasthenia gravis: a systematic review and meta-analysis.Immunologic research · 2026Pooled it
- Role of complement and complement-targeted therapeutics in neurological diseases.Nature reviews. Neurology · 2026Review
- Practical Guidance on Initiating and Switching Targeted Immunotherapies in Generalised Myasthenia Gravis: A German-Austrian Expert Opinion Paper.European journal of neurology · 2026Article
- Bispecific chimeric autoantibody receptor T cells eliminate acetylcholine receptor-specific B cells in myasthenia gravis models.Nature communications · 2026Article
- Eculizumab in Myasthenia Gravis: A Multicenter Retrospective Real-World Study in China.Neurology and therapy · 2026Article
- The role and mechanism of IL‑35 in myasthenia gravis (Review).International journal of molecular medicine · 2026Review
- 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
- Engineered Bi-Specific AChR CAAR T Cells for Selective Elimination of Myasthenia Gravis B Cells.Research square · 2026Article
- Delayed recovery following myasthenic exacerbation and subsequent endplate-protecting treatment.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Article
- Complement C5 inhibition in generalized myasthenia gravis is associated with improved survival and increased cardiovascular risk.Frontiers in immunology · 2026Article
- FcRn antagonist and C5 complement inhibitor as early rescue strategies in severe Myasthenia Gravis: a two-case report.Frontiers in immunology · 2026Article
- Research Progress in Pharmacological Targeted Therapy for Myasthenia Gravis.Journal of inflammation research · 2026Review
- Emergency use of eculizumab in impending and manifest myasthenic crisis: a retrospective case series.Therapeutic advances in neurological disorders · 2026Article
- Therapeutic IgG- and IgM-specific proteases disarm the acetylcholine receptor autoantibodies that drive myasthenia gravis pathology.Proceedings of the National Academy of Sciences of the United States of America · 2025Article
- Dynamic Changes in Peripheral Immune Cells During Efgartigimod Treatment in Naive Generalized Myasthenia Gravis.CNS neuroscience & therapeutics · 2025Article
- Therapeutic strategies targeting complement in myasthenia gravis patients.Journal of neurology · 2025Review
- Ravulizumab for generalized Myasthenia Gravis: a multicenter real-life experience.Journal of neurology · 2025Article
- New and Emerging Biological Therapies for Myasthenia Gravis: A Focussed Review for Clinical Decision-Making.BioDrugs : clinical immunotherapeutics, biopharmaceuticals and gene therapy · 2025Review
- Telitacicept demonstrates high probability of efficacy in myasthenia gravis: a Bayesian real-world study.Frontiers in neurology · 2025Article
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Authors and funding
17 authors.
Frauke StascheitFrom the Department of Neurology with Experimental Neurology (F.S., S.L., M.S., M.H., P.D., L.M.G., S.H., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin; Neuroscience Clinical Research Center (F.S., S.L., M.S., M.H., P.D., L.M.G., S.H., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin; Department of Neurology with Institute of Translational Neurology (C.D.F.S., M.B., C.W.K., L.K., H.W., J.D.L.), University Hospital Münster; Institute of Biometry and Clinical Epidemiology (A.A.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin; Center for Stroke Research Berlin (A.A., M.S., A.M.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Germany; Department of Immunology (K.L.), Hellenic Pasteur Institute; and 2nd Neurology Department (J.T.), School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Greece.ORCID 0000-0001-5306-7880
Carla Daiane Ferreira de SousaFrom the Department of Neurology with Experimental Neurology (F.S., S.L., M.S., M.H., P.D., L.M.G., S.H., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin; Neuroscience Clinical Research Center (F.S., S.L., M.S., M.H., P.D., L.M.G., S.H., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin; Department of Neurology with Institute of Translational Neurology (C.D.F.S., M.B., C.W.K., L.K., H.W., J.D.L.), University Hospital Münster; Institute of Biometry and Clinical Epidemiology (A.A.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin; Center for Stroke Research Berlin (A.A., M.S., A.M.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Germany; Department of Immunology (K.L.), Hellenic Pasteur Institute; and 2nd Neurology Department (J.T.), School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Greece.ORCID 0009-0001-3685-3422
Annette AignerFrom the Department of Neurology with Experimental Neurology (F.S., S.L., M.S., M.H., P.D., L.M.G., S.H., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin; Neuroscience Clinical Research Center (F.S., S.L., M.S., M.H., P.D., L.M.G., S.H., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin; Department of Neurology with Institute of Translational Neurology (C.D.F.S., M.B., C.W.K., L.K., H.W., J.D.L.), University Hospital Münster; Institute of Biometry and Clinical Epidemiology (A.A.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin; Center for Stroke Research Berlin (A.A., M.S., A.M.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Germany; Department of Immunology (K.L.), Hellenic Pasteur Institute; and 2nd Neurology Department (J.T.), School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Greece.ORCID 0000-0003-4891-8921
Malina BehrensFrom the Department of Neurology with Experimental Neurology (F.S., S.L., M.S., M.H., P.D., L.M.G., S.H., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin; Neuroscience Clinical Research Center (F.S., S.L., M.S., M.H., P.D., L.M.G., S.H., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin; Department of Neurology with Institute of Translational Neurology (C.D.F.S., M.B., C.W.K., L.K., H.W., J.D.L.), University Hospital Münster; Institute of Biometry and Clinical Epidemiology (A.A.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin; Center for Stroke Research Berlin (A.A., M.S., A.M.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Germany; Department of Immunology (K.L.), Hellenic Pasteur Institute; and 2nd Neurology Department (J.T.), School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Greece.
Christian W KellerFrom the Department of Neurology with Experimental Neurology (F.S., S.L., M.S., M.H., P.D., L.M.G., S.H., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin; Neuroscience Clinical Research Center (F.S., S.L., M.S., M.H., P.D., L.M.G., S.H., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin; Department of Neurology with Institute of Translational Neurology (C.D.F.S., M.B., C.W.K., L.K., H.W., J.D.L.), University Hospital Münster; Institute of Biometry and Clinical Epidemiology (A.A.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin; Center for Stroke Research Berlin (A.A., M.S., A.M.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Germany; Department of Immunology (K.L.), Hellenic Pasteur Institute; and 2nd Neurology Department (J.T.), School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Greece.ORCID 0000-0003-2276-0003
Luisa KlotzFrom the Department of Neurology with Experimental Neurology (F.S., S.L., M.S., M.H., P.D., L.M.G., S.H., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin; Neuroscience Clinical Research Center (F.S., S.L., M.S., M.H., P.D., L.M.G., S.H., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin; Department of Neurology with Institute of Translational Neurology (C.D.F.S., M.B., C.W.K., L.K., H.W., J.D.L.), University Hospital Münster; Institute of Biometry and Clinical Epidemiology (A.A.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin; Center for Stroke Research Berlin (A.A., M.S., A.M.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Germany; Department of Immunology (K.L.), Hellenic Pasteur Institute; and 2nd Neurology Department (J.T.), School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Greece.ORCID 0000-0001-5439-9633
Sophie LehnererFrom the Department of Neurology with Experimental Neurology (F.S., S.L., M.S., M.H., P.D., L.M.G., S.H., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin; Neuroscience Clinical Research Center (F.S., S.L., M.S., M.H., P.D., L.M.G., S.H., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin; Department of Neurology with Institute of Translational Neurology (C.D.F.S., M.B., C.W.K., L.K., H.W., J.D.L.), University Hospital Münster; Institute of Biometry and Clinical Epidemiology (A.A.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin; Center for Stroke Research Berlin (A.A., M.S., A.M.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Germany; Department of Immunology (K.L.), Hellenic Pasteur Institute; and 2nd Neurology Department (J.T.), School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Greece.ORCID 0000-0001-9007-027X
Maike SteinFrom the Department of Neurology with Experimental Neurology (F.S., S.L., M.S., M.H., P.D., L.M.G., S.H., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin; Neuroscience Clinical Research Center (F.S., S.L., M.S., M.H., P.D., L.M.G., S.H., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin; Department of Neurology with Institute of Translational Neurology (C.D.F.S., M.B., C.W.K., L.K., H.W., J.D.L.), University Hospital Münster; Institute of Biometry and Clinical Epidemiology (A.A.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin; Center for Stroke Research Berlin (A.A., M.S., A.M.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Germany; Department of Immunology (K.L.), Hellenic Pasteur Institute; and 2nd Neurology Department (J.T.), School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Greece.ORCID 0009-0002-1514-8385
Meret HerdickFrom the Department of Neurology with Experimental Neurology (F.S., S.L., M.S., M.H., P.D., L.M.G., S.H., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin; Neuroscience Clinical Research Center (F.S., S.L., M.S., M.H., P.D., L.M.G., S.H., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin; Department of Neurology with Institute of Translational Neurology (C.D.F.S., M.B., C.W.K., L.K., H.W., J.D.L.), University Hospital Münster; Institute of Biometry and Clinical Epidemiology (A.A.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin; Center for Stroke Research Berlin (A.A., M.S., A.M.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Germany; Department of Immunology (K.L.), Hellenic Pasteur Institute; and 2nd Neurology Department (J.T.), School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Greece.
Paolo DoksaniFrom the Department of Neurology with Experimental Neurology (F.S., S.L., M.S., M.H., P.D., L.M.G., S.H., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin; Neuroscience Clinical Research Center (F.S., S.L., M.S., M.H., P.D., L.M.G., S.H., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin; Department of Neurology with Institute of Translational Neurology (C.D.F.S., M.B., C.W.K., L.K., H.W., J.D.L.), University Hospital Münster; Institute of Biometry and Clinical Epidemiology (A.A.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin; Center for Stroke Research Berlin (A.A., M.S., A.M.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Germany; Department of Immunology (K.L.), Hellenic Pasteur Institute; and 2nd Neurology Department (J.T.), School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Greece.ORCID 0009-0009-5381-5995
Lea M GerischerFrom the Department of Neurology with Experimental Neurology (F.S., S.L., M.S., M.H., P.D., L.M.G., S.H., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin; Neuroscience Clinical Research Center (F.S., S.L., M.S., M.H., P.D., L.M.G., S.H., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin; Department of Neurology with Institute of Translational Neurology (C.D.F.S., M.B., C.W.K., L.K., H.W., J.D.L.), University Hospital Münster; Institute of Biometry and Clinical Epidemiology (A.A.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin; Center for Stroke Research Berlin (A.A., M.S., A.M.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Germany; Department of Immunology (K.L.), Hellenic Pasteur Institute; and 2nd Neurology Department (J.T.), School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Greece.ORCID 0000-0001-5746-068X
Sarah HoffmannFrom the Department of Neurology with Experimental Neurology (F.S., S.L., M.S., M.H., P.D., L.M.G., S.H., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin; Neuroscience Clinical Research Center (F.S., S.L., M.S., M.H., P.D., L.M.G., S.H., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin; Department of Neurology with Institute of Translational Neurology (C.D.F.S., M.B., C.W.K., L.K., H.W., J.D.L.), University Hospital Münster; Institute of Biometry and Clinical Epidemiology (A.A.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin; Center for Stroke Research Berlin (A.A., M.S., A.M.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Germany; Department of Immunology (K.L.), Hellenic Pasteur Institute; and 2nd Neurology Department (J.T.), School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Greece.
Konstantinos LazaridisFrom the Department of Neurology with Experimental Neurology (F.S., S.L., M.S., M.H., P.D., L.M.G., S.H., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin; Neuroscience Clinical Research Center (F.S., S.L., M.S., M.H., P.D., L.M.G., S.H., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin; Department of Neurology with Institute of Translational Neurology (C.D.F.S., M.B., C.W.K., L.K., H.W., J.D.L.), University Hospital Münster; Institute of Biometry and Clinical Epidemiology (A.A.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin; Center for Stroke Research Berlin (A.A., M.S., A.M.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Germany; Department of Immunology (K.L.), Hellenic Pasteur Institute; and 2nd Neurology Department (J.T.), School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Greece.ORCID 0000-0003-4386-2578
John TzartosFrom the Department of Neurology with Experimental Neurology (F.S., S.L., M.S., M.H., P.D., L.M.G., S.H., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin; Neuroscience Clinical Research Center (F.S., S.L., M.S., M.H., P.D., L.M.G., S.H., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin; Department of Neurology with Institute of Translational Neurology (C.D.F.S., M.B., C.W.K., L.K., H.W., J.D.L.), University Hospital Münster; Institute of Biometry and Clinical Epidemiology (A.A.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin; Center for Stroke Research Berlin (A.A., M.S., A.M.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Germany; Department of Immunology (K.L.), Hellenic Pasteur Institute; and 2nd Neurology Department (J.T.), School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Greece.ORCID 0000-0002-8153-5300
Heinz WiendlFrom the Department of Neurology with Experimental Neurology (F.S., S.L., M.S., M.H., P.D., L.M.G., S.H., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin; Neuroscience Clinical Research Center (F.S., S.L., M.S., M.H., P.D., L.M.G., S.H., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin; Department of Neurology with Institute of Translational Neurology (C.D.F.S., M.B., C.W.K., L.K., H.W., J.D.L.), University Hospital Münster; Institute of Biometry and Clinical Epidemiology (A.A.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin; Center for Stroke Research Berlin (A.A., M.S., A.M.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Germany; Department of Immunology (K.L.), Hellenic Pasteur Institute; and 2nd Neurology Department (J.T.), School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Greece.ORCID 0000-0003-4310-3432
Andreas MeiselFrom the Department of Neurology with Experimental Neurology (F.S., S.L., M.S., M.H., P.D., L.M.G., S.H., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin; Neuroscience Clinical Research Center (F.S., S.L., M.S., M.H., P.D., L.M.G., S.H., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin; Department of Neurology with Institute of Translational Neurology (C.D.F.S., M.B., C.W.K., L.K., H.W., J.D.L.), University Hospital Münster; Institute of Biometry and Clinical Epidemiology (A.A.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin; Center for Stroke Research Berlin (A.A., M.S., A.M.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Germany; Department of Immunology (K.L.), Hellenic Pasteur Institute; and 2nd Neurology Department (J.T.), School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Greece.ORCID 0000-0001-7233-5342
Jan D LünemannFrom the Department of Neurology with Experimental Neurology (F.S., S.L., M.S., M.H., P.D., L.M.G., S.H., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin; Neuroscience Clinical Research Center (F.S., S.L., M.S., M.H., P.D., L.M.G., S.H., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin; Department of Neurology with Institute of Translational Neurology (C.D.F.S., M.B., C.W.K., L.K., H.W., J.D.L.), University Hospital Münster; Institute of Biometry and Clinical Epidemiology (A.A.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin; Center for Stroke Research Berlin (A.A., M.S., A.M.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Germany; Department of Immunology (K.L.), Hellenic Pasteur Institute; and 2nd Neurology Department (J.T.), School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Greece.ORCID 0000-0002-3007-708X
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesBiologics that target pathogenic antibodies (Abs) and their effector functions such as the complement inhibitor ravulizumab and the neonatal Fc receptor agonist efgartigimod have recently been approved for the treatment of acetylcholine receptor (AChR)-Ab-positive myasthenia gravis (MG), but comparative studies are lacking.
methodsIn a prospective, exploratory real-world study, we assessed clinical efficacy, safety, and biological effects of ravulizumab and efgartigimod treatment initiation. Myasthenia Gravis-Activities of Daily Living and Quantitative Myasthenia Gravis scores were used as clinical endpoints. Ab effector functions were determined by AChR-Ab-dependent complement activation and phagocytosis assays and systemic complement activation profiling.
resultsWe observed similar moderate short-term efficacy of ravulizumab and efgartigimod in achieving clinical improvement. Ravulizumab reduced systemic terminal complement activation, but neither treatment showed significant effects on complement pathways proximal to C5 or functional capacities of AChR-Abs. Both treatment modalities were well tolerated with no serious adverse events reported. DISCUSSION: Clinical benefits obtained with ravulizumab and efgartigimod can be remarkably heterogeneous in daily clinical practice. Neither treatment relevantly changed effector functions of pathogenic AChR-Abs, supporting the concept that durable disease control in MG requires continuous administration of both fast-acting agents. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that in AChR-Ab-positive patients with generalized MG, ravulizumab and efgartigimod provide comparable modest improvement in MG functional scales.
Indexed as
Antibodies, Monoclonal, HumanizedMyasthenia GravisAdultAgedFemaleHumansMaleMiddle AgedProspective StudiesAntibodies, Monoclonal, Humanizedravulizumab
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