ArticleNeurology and therapy2026
Eculizumab in Myasthenia Gravis: A Multicenter Retrospective Real-World Study in China.
Article in Neurology and therapy, 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
introductionMyasthenia gravis (MG) is a chronic autoimmune neuromuscular disorder needing long-term immunosuppressive therapy. Eculizumab is a promising treatment, but real-world evidence on its efficacy and safety is limited.
methodsThis retrospective cohort study across six medical centers enrolled 60 patients with MG on eculizumab. Clinical data, including MG-Activities of Daily Living (MG-ADL) scores, quantitative MG scores (QMG), and oral corticosteroid dosage at baseline, weeks 1, 4, and 8, and final follow-up were obtained. Outcomes included score changes, post-intervention status (PIS), and safety profile.
resultsBy week 8, 30.95% of patients achieved minimal manifestation status (MMS) or better, increasing to 32.69% at final follow-up. Mean ADL scores significantly dropped from 8.18 ± 3.99 at baseline to 5.59 ± 3.72 at week 1, 3.78 ± 3.42 at week 4, 3.50 ± 2.92 at week 8, and 3.33 ± 3.56 during final follow-up (p < 0.0001). Clinically meaningful improvement (CMI) was observed in 56.9%, 70.0%, 85.0%, and 76.27% at the respective time points. Both thymoma-associated and non-thymoma subgroups showed significant ADL improvement (p ≤ 0.026) with mixed-effects modeling revealing significant group × time interaction (p = 0.01).The thymoma-associated MG (TAMG) group had a faster initial response, with subsequent outcomes comparable between the two groups. Among the 37 patients (61.67%) who switched from FcRn inhibitor therapy to eculizumab, clinical outcomes were non-inferior to those of direct eculizumab recipients and the magnitude of MG-ADL improvement was comparable to that of the overall treatment group. The mean daily corticosteroid dose decreased from 21.21 ± 13.68 mg at baseline to 13.32 ± 10.42 mg at final follow-up (p < 0.0001) Adverse events were rare, with no treatment-related serious events.
conclusionEculizumab provides rapid and sustained clinical improvement in patients with MG, with a favorable safety profile. Patients with TAMG show a faster initial response. For patients with an inadequate response to FcRn inhibitors, eculizumab remains an effective rescue strategy.
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