Observational studyJournal of neurology, neurosurgery, and psychiatry2025
C5 complement inhibition versus FcRn modulation in generalised myasthenia gravis.
Observational study in Journal of neurology, neurosurgery, and psychiatry, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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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.
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.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled 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
- Anti-C2-mediated complement inhibition prevents disease in a rat passive transfer model of myasthenia gravis.Journal of translational autoimmunity · 2026Article
- Practical Guidance on Initiating and Switching Targeted Immunotherapies in Generalised Myasthenia Gravis: A German-Austrian Expert Opinion Paper.European journal of neurology · 2026Article
- Aseptic Meningitis Following Rozanolixizumab in a Patient With Refractory Anti-MuSK Positive Myasthenia Gravis: A Case Report.The Neurohospitalist · 2026Article
- Limitations of Complement Activity Assays as Biomarkers for Ravulizumab Therapeutic Monitoring.Annals of clinical and translational neurology · 2026Article
- Complement Inhibition Therapy in Myasthenic Crisis-A Multicentre Retrospective Analysis of 17 Cases From Germany.European journal of neurology · 2026Article
- Early versus late add-on therapy in generalized myasthenia gravis: a multicenter real-world cohort study.Journal of neurology · 2026Observational
- 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
- 1-Year Clinical Outcome Post-Myasthenic Crisis: A Multicenter Prospective Study in China.European journal of neurology · 2026Article
- Complement C5 inhibition in generalized myasthenia gravis is associated with improved survival and increased cardiovascular risk.Frontiers in immunology · 2026Article
- Development and External Validation of a Multivariable Model to Predict Early Minimal Symptom Expression Response in Adult Generalized Myasthenia Gravis Patients Treated With Efgartigimod.CNS neuroscience & therapeutics · 2026Article
- Effectiveness and safety of telitacicept in refractory ocular myasthenia gravis: a retrospective, real-world study.Frontiers in immunology · 2026Observational
- Heterogeneous response to efgartigimod in real-world experience with myasthenia gravis: Predictors and treatment strategies.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2026Article
- CD19xCD3 T cell engager blinatumomab effective in refractory generalized myasthenic syndromes.Molecular therapy : the journal of the American Society of Gene Therapy · 2025Article
- Complement inhibitor therapy in thymoma-associated myasthenia gravis: a real-world experience.Frontiers in immunology · 2025Article
- Safety profile of complement C5 inhibitors and FcRn inhibitors in the treatment of myasthenia gravis: analysis of the FAERS database and disease-gene interaction network.Frontiers in immunology · 2025Article
- Efgartigimod for generalized myasthenia gravis: a comprehensive review of clinical evidence and future perspectives.Frontiers in neurologyReview
Corrections and comments
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Authors and funding
25 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMyasthenia gravis (MG) is an autoimmune disorder affecting neuromuscular junctions, leading to fluctuating muscle weakness. While many patients respond well to standard immunosuppression, a substantial subgroup faces ongoing disease activity. Emerging treatments such as complement factor C5 inhibition (C5IT) and neonatal Fc receptor (FcRn) antagonism hold promise for these patients. However, the current landscape is hindered by a paucity of comparative data that is crucial for treatment decisions.
objectiveThis study aims to compare the effectiveness and safety of C5IT and FcRn antagonists in a real-world setting.
methodsA retrospective analysis of 153 MG patients from 8 German specialised MG centres receiving either C5IT (26 eculizumab, 80 ravulizumab) or efgartigimod (47 patients) was conducted. Propensity score matching (PSM) was employed to compare changes in MG-specific outcome parameters within the first 6 months after treatment initiation, along with safety profiles and concomitant MG therapy.
resultsBoth treatment strategies led to rapid clinical improvements and substantial reductions in prednisolone doses. However, insufficient response was noted in 20%-49.1% of patients based on Quantitative MG and MG Activities of Daily Living (MG-ADL) scores. We did not identify any new safety concerns. After PSM, 40 patients remained in each group. In both cohorts, reductions in MG-ADL as prespecified primary study endpoint were comparable. Moreover, analyses of secondary outcome parameters demonstrated similar results for C5IT versus FcRn.
conclusionIn contrast to current meta-analyses and indirect comparisons of clinical trial data, our real-world study demonstrates comparable efficacy and safety of C5IT and FcRn antagonism in MG.
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