ArticleFrontiers in immunology2026
Real-world study of efgartigimod in AChR antibody-positive generalized myasthenia gravis: thymus status, multi-domain symptom improvement and steroid-sparing effect.
Article in Frontiers in immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Efgartigimod has been approved for the treatment of gMG. However, real-world evidence regarding its efficacy across various functional domains in patients with differing thymic statuses, as well as its steroid-sparing effect when used in conjunction with conventional immunotherapy, remains limited. Methods: This single-center, real-world retrospective study included AChR antibody-positive patients with gMG who underwent at least two cycles of efgartigimod. The primary endpoints were the changes in MG-ADL and QMG scores at weeks 4 and 8. Secondary endpoints encompassed the MSE rate, IgG reduction, subgroup analyses stratified by thymic status and treatment regimens, and improvements in ocular, bulbar, limb, and trunk functional domains. Generalized estimating equations were employed for the analysis of longitudinal data. Results: A total of 62 patients participated in the study, comprising 32 females and 30 males, with a mean age of 55 ± 14 years. Significant improvements in the MG-ADL (mean: 4.55 points) and QMG scores (mean: 7.52 points) were noted at week 4 (all Conclusion: Efgartigimod rapidly, significantly, and sustainably alleviates symptoms in patients with AChR antibody-positive gMG, with its efficacy remaining unaffected by thymic status or concurrent immunotherapy. Patients with thymic abnormalities exhibit an earlier therapeutic response; however, long-term outcomes are comparable to those of patients with a normal thymus. The extent of improvement varies across functional domains, with the most pronounced benefits observed in ocular symptoms. Efgartigimod demonstrates independent therapeutic effects and facilitates substantial tapering of steroids when administered alongside glucocorticoids, underscoring its significant clinical value.
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