ArticleAnnals of clinical and translational neurology2026
Inhibition of Classical and Alternative Complement Pathway by Ravulizumab and Eculizumab.
Article in Annals of clinical and translational neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Limitations of Complement Activity Assays as Biomarkers for Ravulizumab Therapeutic Monitoring.Annals of clinical and translational neurology · 2026Article
- Reply to Letter: "Limitations of Complement Activity Assays as Biomarkers for Ravulizumab Therapeutic Monitoring" by Saccà and Pelto Regarding "Inhibition of Classical and Alternative Complement Pathway by Ravulizumab and Eculizumab".Annals of clinical and translational neurology · 2026Article
- Inhibition of Classical and Alternative Complement Pathway by Ravulizumab and Eculizumab.Annals of clinical and translational neurology · 2026Article
- Complement C5 inhibition with eculizumab or ravulizumab is associated with increased cardiovascular and thromboembolic risk after ST-elevation myocardial infarction: a propensity-matched global retrospective cohort study.BMC cardiovascular disorders · 2026Observational
- Molecular, Metabolic and Inflammatory Patterns Involved in Pathogenesis of Anderson-Fabry Disease.Cells · 2026Review
- Clinical study of eculizumab with or with not tacrolimus in the treatment of generalized myasthenia gravis.Frontiers in immunology · 2026Article
- CFDFrontiers in immunology · 2026Article
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Authors and funding
15 authors.
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No grant is acknowledged in the PubMed record.
Abstract
objectiveTo explore the feasibility of classical (CH50) and alternative (AH50) complement pathway activity as potential biomarkers for treatment guidance and monitoring during therapy with ravulizumab in patients with generalized myasthenia gravis (gMG) and compare these to therapeutic drug monitoring under eculizumab.
methodsIn this prospective, exploratory real-world study CH50 and AH50, eculizumab and ravulizumab blood levels were assessed in patients with acetylcholine-receptor-antibody (AChR-ab) positive gMG. Patients were either pretreated with eculizumab or C5-inhibitor naïve. Samples were collected before the next infusion (end-of-dose). Laboratory data were correlated with patient-reported subjective duration of the ravulizumab effect.
resultsOverall, 61 patients were enrolled. At the end of their respective dosing interval, median AH50 levels were more strongly suppressed with eculizumab than with ravulizumab (1% [0%-2%] versus 5% [3%-9%]; Cohen's d 2.2 [95% CI 1.5-2.8]). Patients who discontinued ravulizumab due to insufficient effects (n = 19; 33%) had higher median AH50 levels than those who continued (7% [4%-13%] versus 5% [3%-8%]; Cohen's d -0.9 [95% CI -1.3 to -0.4]). In 81% (n = 46) of patients, the therapeutic effect of ravulizumab diminished before the subsequent infusion after the standard 8-week interval. Higher AH50 levels were correlated with earlier symptom recurrence.
interpretationOur results indicate potential differences in the ability of eculizumab and ravulizumab to suppress complement pathway activity through their respective dosing intervals. Additionally, higher AH50 levels might be a potential biomarker to predict poor therapy response and faster wearing off of ravulizumab's effect. However, these findings need to be validated in large multicenter studies.
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