A small retrospective study in BMJ Neurology Open suggests that secukinumab, a drug that blocks the inflammatory protein interleukin-17A (IL-17A), may improve symptoms and quality of life in people with generalized myasthenia gravis (MG) who have acetylcholine receptor (AChR) antibodies.
Researchers at Peking University People’s Hospital evaluated 29 adults with AChR antibody–positive generalized MG who received secukinumab for 24 weeks. All patients continued on stable background MG treatments, such as pyridostigmine, corticosteroids or other immunosuppressants, while they were given secukinumab on a standard dosing protocol.
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By week 24, patients exhibited significant improvements on several standard MG scales. Average Quantitative Myasthenia Gravis (QMG) scores decreased by about 61%, MG Activities of Daily Living (MG-ADL) scores by 64%, and MG-QOL15 quality-of-life scores by 58% compared to baseline. Meaningful clinical benefits first appeared at week 8, when QMG scores had already decreased by 25%.
Levels of AChR antibodies, a key cause of muscle weakness in MG, also decreased rapidly. Antibody levels dropped nearly 60% at week 4 and approximately 69% by week 24. These reductions in AChR antibody levels were closely associated with improvements in QMG, MG-ADL and MG-QOL15 scores, indicating that secukinumab’s benefits may be linked to reducing harmful autoantibodies.
The researchers also examined immune cells and signaling proteins that may contribute to MG. Before treatment, patients exhibited higher levels of IL-17A, IL-6 and certain T cell subsets than healthy controls. After 24 weeks of secukinumab, IL-17A levels decreased by about 84%, Th17 cells by 68%, Tfh cells by nearly 72% and IL-6 levels by 78%. These changes generally correlated with clinical improvements, supporting IL-17A as a potential treatment target in MG.
Overall, secukinumab was well tolerated in this study. Two patients developed mild skin reactions at the injection site and one had flu-like symptoms, but no serious side effects were reported over the 24-week follow-up.
“This study provides real-world evidence that secukinumab induces rapid and substantial improvements in clinical scores and quality of life in patients with AChR antibody-positive MG,” the authors wrote, adding that these benefits were linked to “suppression of pathogenic Th17/T follicular helper cells, downregulation of the IL-17A/IL-6 axis and reduction in autoantibody levels.”
Because this was a small, retrospective study without a control group receiving standard therapy alone, the authors emphasized that larger, randomized trials are needed to confirm the safety and effectiveness of IL-17A inhibition for people living with MG.
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