Evidence map›Paper›PMID 41837820›Full record

Observational studyCNS neuroscience & therapeutics2026

Double-Filtration Plasmapheresis Versus Efgartigimod for Generalized Myasthenia Gravis: Severity-Stratified Benefits in a Prospective Observational Multicenter Study.

Kan Wang, Hanyu Xin, Mengze Zhang, Qiuju Li, Yanan Wu, Xia Li, Jing Peng, Chong Xie, Xiajun Zhou, Li Gao and 7 more

Abstract readMulticenter StudyObservational StudyComparative Study
In one paragraph

Observational study in CNS neuroscience & therapeutics, 2026. 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

17 authors.

Kan WangDepartment of Neurology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Hanyu XinDepartment of Neurology, Punan Branch of Renji Hospital, School of Medicine, Shanghai Jiao Tong University (Punan Hospital in Pudong New District, Shanghai), Shanghai, China.
Mengze ZhangDepartment of Neurology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Qiuju LiDepartment of Neurology, Punan Branch of Renji Hospital, School of Medicine, Shanghai Jiao Tong University (Punan Hospital in Pudong New District, Shanghai), Shanghai, China.
Yanan WuDepartment of Neurology, Anhui No. 2 Provincial People's Hospital, Hefei, China.
Xia LiDepartment of Neurology, Anhui No. 2 Provincial People's Hospital, Hefei, China.
Jing PengDepartment of Neurology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Chong XieDepartment of Neurology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Xiajun ZhouDepartment of Neurology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Li GaoDepartment of Neurology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Xuzhong PeiDepartment of Neurology, Punan Branch of Renji Hospital, School of Medicine, Shanghai Jiao Tong University (Punan Hospital in Pudong New District, Shanghai), Shanghai, China.
Yiwei YangHangzhou Dian Medical Laboratory Co., Ltd., Hangzhou, China.
Yuhui WangDepartment of Neurology, Punan Branch of Renji Hospital, School of Medicine, Shanghai Jiao Tong University (Punan Hospital in Pudong New District, Shanghai), Shanghai, China.
Yuan ZhongSchool of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Lu ZhangDepartment of Neurology, Anhui No. 2 Provincial People's Hospital, Hefei, China.
Desheng ZhuDepartment of Neurology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.ORCID 0000-0003-2454-2173
Yangtai GuanDepartment of Neurology, Punan Branch of Renji Hospital, School of Medicine, Shanghai Jiao Tong University (Punan Hospital in Pudong New District, Shanghai), Shanghai, China.ORCID 0000-0003-0813-4073

Funding

National Natural Science Foundation of China 82301527Shanghai Jiao Tong University YG2023LC04Shanghai Pudong New Area Health Commission 2024-PWXZ-16Shanghai Pudong New Area Health Commission PW2022E-01Shanghai Pudong New Area Health Commission PWRq2025-23
6 · The paper itself

Abstract

introductionDouble-Filtration plasmapheresis (DFPP) and efgartigimod (EFG) are both effective acute exacerbation therapies for generalized myasthenia gravis (gMG), yet real-world comparative evidence remains limited. This study aims to systematically compare their clinical efficacy and safety to guide individualized treatment strategies.

methodsThis prospective multicenter study (Aug 2019-Mar 2025) evaluated gMG patients treated with a cycle of DFPP (3-5 sessions) or EFG (4 weekly infusions). Primary endpoints included changes in Quantitative Myasthenia Gravis (QMG) and Myasthenia Gravis Activities of Daily Living (MG-ADL) scores from baseline (T0) to post-treatment (T1) and 1 month after T1 (T2). Secondary endpoints covered clinical meaningful improvement (CMI), deep improvement rates (defined as ≥ 5-point reduction in MG-ADL or ≥ 9-point in QMG), immunological changes, and safety.

resultsAmong 66 MG patients (EFG = 41, DFPP = 25), both DFPP and EFG significantly reduced QMG and MG-ADL scores at T1 and T2. In moderate-to-severe gMG (MGFA ≥ IIb), 3/5-session DFPP was superior to 4-infusion EFG at T2 (p < 0.05), while efficacy was comparable in mild cases (MGFA ≤ IIa). Sustained CMI rates (through T2) increased with higher treatment intensity; the 5-session DFPP rate was significantly higher than the 3-session DFPP (85% vs. 45%, p = 0.049) and numerically higher than the 4-infusion EFG (85% vs. 70%, p = 0.413). The proportion of patients achieving deep improvement in 5-session DFPP was higher than 4-infusion EFG. DFPP broadly reduced immunoglobulins/complement versus EFG's selective immunoglobulin G (IgG) reduction. Adverse events occurred in 28.0% of the DFPP group (mainly catheter-related thrombosis) and 39.0% of the EFG group (predominantly headache; p = 0.431), with no serious events reported.

conclusionBoth DFPP and EFG effectively treat gMG, though DFPP offers greater benefit in moderate-to-severe cases, underscoring the need for individualized therapy.

Indexed as

Myasthenia GravisPlasmapheresisSeverity of Illness IndexActivities of Daily LivingAdultAgedFemaleHumansMaleMiddle AgedProspective StudiesTreatment Outcomeclinical efficacydouble‐filtration plasmapheresisefgartigimodgeneralized myasthenia gravisstratified therapy

Identifiers

PMID41837820
PMCPMC13093381

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Registered trials

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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.