In one paragraphArticle in European journal of neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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 registryThe 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 literatureWho cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
4 · The recordCorrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
5 · Who and what moneyAuthors and funding
25 authors.
Lea GerischerDepartment of Neurology With Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.ORCID https://orcid.org/0000-0001-5746-068X Maike SteinDepartment of Neurology With Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.ORCID https://orcid.org/0009-0002-1514-8385 Hanna TangenInstitute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Johanna LorisDepartment of Neurology, University Medical Center Göttingen, Göttingen, Germany.
Melina SchlagDepartment of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-30 TBNS), university Medicine Essen, Essen, Germany.
Menekse OeztuerkDepartment of Neurology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
Paolo DoksaniDepartment of Neurology With Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.ORCID https://orcid.org/0009-0009-5381-5995 Carla DusemundDepartment of Neurology With Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.ORCID https://orcid.org/0000-0001-6477-8901 Meret HerdickDepartment of Neurology With Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.ORCID https://orcid.org/0000-0003-0119-9499 Julia Herzig-NichtweißDepartment of Neurology With Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.ORCID https://orcid.org/0000-0002-5365-8231 Philipp MergenthalerDepartment of Neurology With Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.ORCID https://orcid.org/0000-0002-9753-6711 Frauke StascheitDepartment of Neurology With Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.ORCID https://orcid.org/0000-0001-5306-7880 Amani SubohDepartment of Neurology With Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Lisa SchwarzDepartment of Neurology With Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.ORCID https://orcid.org/0000-0002-1283-3478 Sarah HoffmannDepartment of Neurology With Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.ORCID https://orcid.org/0000-0001-9549-2594 Andreas MeiselDepartment of Neurology With Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.ORCID https://orcid.org/0000-0001-7233-5342 Sophie LehnererDepartment of Neurology With Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.ORCID https://orcid.org/0000-0001-9007-027X Funding
No grant is acknowledged in the PubMed record.
6 · The paper itselfAbstract
introductionGeneralized myasthenia gravis (gMG) may progress to life-threatening myasthenic crises (MC) requiring mechanical ventilation. Standard therapy includes intravenous immunoglobulins (IVIg), plasmapheresis (PLEX), immunoadsorption (IA), and high-dose corticosteroids. This study aimed to evaluate the real-world effectiveness of complement-inhibitors (C5-I) in patients refractory to the standard treatment of MC (termed therapy-refractory MC).
methodsThis multicentre, retrospective study included patients with acetylcholine-receptor-antibody positive (AChR-ab+) gMG experiencing MC or severe exacerbations (MGFA IVb/V) treated with eculizumab or ravulizumab in the intensive or intermediate care unit (ICU/IMC). The primary outcome was the proportion of patients discharged from ICU/IMC within six weeks after C5-I initiation (German Clinical Trials Registry; DRKS00032104).
resultsAmong 17 identified cases, seven had thymoma-associated MG (TAMG) and 10 had late-onset MG; median age was 77 years. Five patients required non-invasive and 12 invasive ventilation; nine underwent tracheotomy. Therapies included IVIg, PLEX, IA, and corticosteroids. Rituximab was added in two cases. Twelve patients received eculizumab and five ravulizumab. Median hospitalization before C5-I initiation was 32 days (IQR 22-50) and median ICU-stay was 17 days (IQR 4.5-35) thereafter. Fourteen patients (82%) reached the primary outcome. Two patients died due to bacterial sepsis; no meningococcal infection was observed.
conclusionIn MC or severe exacerbations insufficiently responsive to standard treatment with IVIg and PLEX/IA, add-on C5-I therapy may represent an effective therapeutic approach. Importantly, TAMG, a subtype typically excluded from interventional trials yet often requiring more intensive therapy, also demonstrated clinical improvement. These findings warrant further systematic evaluation of C5-I as adjunctive therapy for AChR-ab+ therapy-refractory MC.
Indexed as
Antibodies, Monoclonal, HumanizedComplement Inactivating AgentsMyasthenia GravisAgedAged, 80 and overFemaleGermanyHumansMaleMiddle AgedRetrospective StudiesTreatment OutcomeAntibodies, Monoclonal, HumanizedComplement Inactivating AgentseculizumabC5‐inhibitioneculizumabmyasthenic crisisneurocritical careravulizumab
Identifiers
PMID41983870
PMCPMC13081792
What OpenQuestion holds
Textmetadata
LicenceCC BY
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