Patients with generalized myasthenia gravis (MG) who began taking efgartigimod were able to lower or stop steroid use while also reporting better symptom control, according to a new analysis of U.S. data published recently in the Journal of the Neurological Sciences.
These results suggest efgartigimod could help people with the condition reduce their reliance on steroids, which are commonly used but carry significant long-term side effects.
“[T]his study demonstrated a significant reduction from baseline in GC [glucocorticoid] utilization within 1 year of efgartigimod initiation among a broad cohort of 266 patients with gMG based on US claims,” explained thise study’s authors. “These findings were consistent with those observed in clinical practice based on recently published case series.”
Among 266 patients who had been on chronic steroids before starting efgartigimod, 26% were able to discontinue steroids completely within 12 months. Another 42% lowered their daily dose to 5 milligrams or less of prednisone, a threshold often considered minimal. Overall, two-thirds of the group achieved a reduction in steroid dosage.
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Importantly, symptom control improved at the same time. In a subgroup of 126 patients with available data, scores on the Myasthenia Gravis Activities of Daily Living scale fell from an average of 7.9 before efgartigimod to 3.1 after treatment. This scale reflects the impact of the disease on daily functions such as chewing, speaking and walking. The improvement was significant even as steroid use declined.
Efgartigimod, an antibody-based therapy, was originally designed to reduce the harmful autoantibodies that drive MG. In this study, benefits extended beyond improved symptoms to include lower reliance on additional treatments such as intravenous immunoglobulin and plasma exchange. By nine to 12 months, the number of patients needing three or more additional therapies dropped from more than half to just one-fifth.
The average daily steroid dose across the entire group dropped steadily over the year, from 17.9 milligrams before efgartigimod to 10.2 milligrams after a year. Women and those who had started on higher doses were more likely to taper successfully.
For patients, these results may offer hope of fewer complications tied to long-term steroid use, such as weight gain, bone loss, diabetes and infections. While the analysis was observational and based on insurance claims, the findings add to growing evidence that efgartigimod can help people with generalized MG achieve better control with less medication burden.
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