Complement inhibitors may help reduce steroid dosage

Using complement inhibitors may lead to a faster reduction in corticosteroid dosage for patients with MG.

Using complement inhibitors, a class of drugs that targets the immune system, can lead to a faster reduction in corticosteroid dosage among patients with myasthenia gravis (MG), according to a study recently published in Therapeutic Advances in Neurological Disorders. 

MG is a rare autoimmune disorder that weakens the neuromuscular system. In other words, the immune system acts against its own body to weaken the nerve-muscle connection, leading to symptoms such as muscle weakness and the incoordination of the eye muscles.

Corticosteroids are often prescribed because they have anti-inflammatory properties that can reduce symptoms. However, persistently high doses of corticosteroids can lead to significant side effects, such as weight gain and facial roundness. 

Patients should receive the lowest corticosteroid dose possible while maintaining symptomatic relief. To this end, researchers investigated if complement inhibitors such as eculizumab and ravulizumab are effective enough to allow a lower dose of corticosteroids.

Researchers analyzed the clinical records of adult patients with acetylcholine receptor generalized MG who received care at an outpatient clinic between June 2020 and November 2024. All patients received one of three treatment regimens: corticosteroids alongside mycophenolate mofetil, azathioprine or complement inhibitors. 

Read more about MG testing and diagnosis 

All these patients saw a reduction in corticosteroid doses over time. However, compared with mycophenolate mofetil and azathioprine, patients on complement inhibitors experienced the most pronounced reduction in their corticosteroid dose.

“[Complement inhibitor] therapy may represent a rapid and effective steroid-sparing [ie, steroid-reducing] option for [generalized myasthenia gravis] patients, reducing the burden of systemic adverse effects associated with prolonged corticosteroid use and improving overall disease management,” researchers concluded. 

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