Evidence map›Paper›PMID 40761829›Full record

ArticleBMJ neurology open2025

Efgartigimod following plasma exchange in the treatment of subjects with generalised myasthenia gravis: study protocol for a multicentre, three-arm, open-label study.

Kan Wang, Qiuju Li, Yanan Wu, Mengze Zhang, Xiaokun Wang, Jing Peng, Chong Xie, Chunran Xue, Song Gao, Li Gao and 5 more

Abstract read
In one paragraph

Article in BMJ neurology open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Observational
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

15 authors.

Kan Wang *Department of Neurology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.ORCID https://orcid.org/0000-0001-9811-4142
Qiuju Li *Department of Neurology, Punan Branch of Renji Hospital, Shanghai Jiaotong University School of Medicine (Punan Hospital in Pudong New District, Shanghai), Shanghai, China.ORCID https://orcid.org/0009-0000-4348-3979
Yanan Wu *Department of Neurology, Anhui NO.2 Provincial People's Hospital, Hefei, Anhui, China.ORCID https://orcid.org/0009-0007-1623-7335
Mengze ZhangDepartment of Neurology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.ORCID https://orcid.org/0009-0000-1115-5129
Xiaokun WangDepartment of Neurology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.ORCID https://orcid.org/0000-0003-0402-9452
Jing PengDepartment of Neurology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.ORCID https://orcid.org/0000-0003-4213-7542
Chong XieDepartment of Neurology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.ORCID https://orcid.org/0000-0001-9604-5921
Chunran XueDepartment of Neurology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.ORCID https://orcid.org/0000-0002-2817-1843
Song GaoHeqing Community Health Service Center, Pudong New Area, Shanghai, Shanghai, China.ORCID https://orcid.org/0000-0002-3980-0246
Li GaoDepartment of Neurology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.ORCID https://orcid.org/0000-0002-3606-4837
Yiwei YangHangzhou Dian Medical Laboratory Co., Ltd, Hangzhou, Zhejiang, China.ORCID https://orcid.org/0000-0002-0010-1050
Yuhui WangDepartment of Neurology, Punan Branch of Renji Hospital, Shanghai Jiaotong University School of Medicine (Punan Hospital in Pudong New District, Shanghai), Shanghai, China.ORCID https://orcid.org/0000-0001-8025-6724
Lu ZhangDepartment of Neurology, Anhui NO.2 Provincial People's Hospital, Hefei, Anhui, China.ORCID https://orcid.org/0009-0005-9929-5420
Yong HaoDepartment of Neurology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.ORCID https://orcid.org/0000-0003-3652-0449
Yangtai GuanDepartment of Neurology, Punan Branch of Renji Hospital, Shanghai Jiaotong University School of Medicine (Punan Hospital in Pudong New District, Shanghai), Shanghai, China.ORCID https://orcid.org/0000-0001-7322-6842

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Myasthenia gravis (MG), an IgG-mediated autoimmune disorder targeting neuromuscular junctions, shows refractory in 12-20% of generalised MG (gMG) patients despite immunotherapies. Plasma exchange (PLEX) transiently depletes pathogenic mediators, while neonatal Fc receptor antagonists (eg, efgartigimod) offer novel therapeutic potential. Both PLEX and efgartigimod require adjunctive non-steroidal immunosuppressive therapy (NSIST) for sustained remission. This study aims to evaluate the effectiveness and safety of efgartigimod working as a bridge treatment after PLEX but before NSIST taking effect, while concurrently conducting a comparative analysis of clinical outcomes between PLEX and efgartigimod in gMG. Methods and analysis: This multicentre, open-label, three-arm trial (n=45 gMG patients) assigns cohorts to PLEX+efgartigimod, PLEX alone or efgartigimod alone. The intervention comprises PLEX and/or efgartigimod. Oral glucocorticoids and cholinesterase inhibitors are allowed during this study. NSIST starts the day after completing PLEX or the second dose of efgartigimod. Outcomes are assessed at weeks 4, 8, 12, 16, 20, 24, 36 and 48. Primary endpoint: proportion achieving minimal symptom expression (MSE) at week 48. Secondary endpoints: median time to first MSE, adverse events (AE) incidence/severity, exacerbation rates, neurological functional assessment scores, cholinesterase inhibitor/corticosteroid usage, serological evolution of immunological markers. All AEs are systematically documented and causality-assessed. Ethics and dissemination: Ethical clearance for this investigation was granted by the Institutional Review Board of Punan Hospital in accordance with Declaration of Helsinki principles. All enrolled participants will provide written informed consent through standardised documentation processes prior to study enrolment. The results will be accessible in peer-reviewed publications. Trial registration number: ChiCTR2500104662.

Indexed as

FC RECEPTORMYASTHENIANEUROIMMUNOLOGY

Identifiers

PMID40761829
PMCPMC12320067

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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.