Efgartigimod is well-tolerated and effective in adult patients with acetylcholine receptor antibody (AChR)-positive generalized myasthenia gravis (MG), according to findings of a recent multicenter analysis. Results were reported in an abstract from the 2026 American Academy of Neurology annual meeting in Chicago.
Efgartigimod is an antibody fragment therapy that treats MG by inhibiting the neonatal Fc receptor. This helps to reduce immunoglobulin G (IgG) antibody levels. Although clinical studies have supported the use of efgartigimod, real-world evidence on long-term outcomes, steroid reduction and response predictors is still scarce.
The retrospective study followed 46 patients across seven centers for an average of 9.8 weeks. Participants received a mean of 4.3 cycles of efgartigimod across the study period.
During this time, 86.9% of participants experienced clinically significant improvements in Myasthenia Gravis Activities of Daily Living (MG-ADL) scores. Furthermore, after just one cycle of efgartigimod 43.5% of patients achieved minimal symptom expression, meaning symptoms didn’t interfere daily life. Just over half of patients (52.2%) achieved minimal symptom expression overall.
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In total, 78.3% of patients maintained an improvement in MG-ADL scores. While some participants experienced temporary reduction in symptoms with each treatment cycle, others reported sustained remission. However, 35.9% discontinued efgartigimod due to a lack of efficacy.
Corticosteroids are a common treatment for MG. Of the 29 patients receiving prednisone, 17 successfully reduced their daily dose from an average of 30.9 mg to 16.8 mg. Individuals with a shorter disease duration had a greater likelihood of successful dose reduction.
Bridging therapy, which refers to the use of drugs to quickly get symptoms under control, worked successfully in five individuals. Those also taking the immunosuppressants azathioprine or mycophenolate had 15 times the odds of successful bridging therapy compared with those not on these drugs.
In addition, 21.7% of patients reported adverse events. All of these events were mild, and only one individual discontinued treatment due to side effects.
“Distinct response patterns, a steroid-sparing effect linked to shorter disease duration, and successful bridging therapy in the presence of immunosuppressant support [efgartigimod’s] role in personalized treatment strategies,” the authors concluded.
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