Myasthenia Gravis Highlights From AANEM

Nicholas Silvestri, MD


October 14, 2022

Several therapeutic advances for myasthenia gravis (MG) emerged at the 2022 American Association of Neuromuscular and Electrodiagnostic Medicine Annual Meeting, as reported by Dr Nicholas Silvestri of the University at Buffalo.

"This is an exciting time in the field of myasthenia gravis," Dr Silvestri says, citing new studies on both neonatal Fc receptor (FcRn) antagonists and complement inhibitors.

Dr Silvestri begins by discussing a subgroup analysis of the ADAPT/ADAPT+ trials which showed that efgartigimod, an FcRn antagonist, was safe and effective in patients with anti-acetylcholine receptor antibody-negative MG, a group for whom few therapies have shown benefit.

In a new three-arm study of rozanolixizumab, both treatment arms of the FcRn antagonist achieved clinically meaningful responses compared with placebo.

Turning to complement inhibitors, Dr Silvestri reports on a positive phase 3 trial of zilucoplan, noting that the agent's subcutaneous mode of delivery is likely to appeal to many MG patients.

Timing of response was examined over 60 weeks in a study of ravulizumab. Almost half of patients achieved a response in 2 weeks, and the median time to first response in patients with Ab+ MG was 4 weeks.

Dr Silvestri closes with a timely study on COVID-19, which indicated that MG patients who have COVID are at increased risk for hospitalization but that vaccination does not exacerbate their disease and is therefore safe and beneficial in this population.


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