Telitacicept is an effective add-on therapy to corticosteroids and immunosuppressants in older adults with myasthenia gravis (MG), according to a recent study published in Clinical Immunology.
Participants who received the drug weekly for just three months experienced significant improvements in patient-reported and biological markers of disease.
Telitacicept works by blocking B-lymphocyte stimulator and a proliferation-inducing ligand, two molecules that play roles in immune system function. It is currently approved in China for individuals with MG, rheumatoid arthritis and systemic lupus erythematosus.
The study included nine patients younger than 65 years and seven patients aged 65 years or older at diagnosis. Overall, participants had a mean age at disease onset of about 62 years. All participants received telitacicept as an add-on therapy either after a suboptimal response to standard treatment or after experiencing early progression or severe disease.
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After one month of treatment, participants experienced significant improvements in Myasthenia Gravis Activities of Daily Living (MG-ADL) and Quantitative Myasthenia Gravis (QMG) scores, two measures of disease severity. Mean scores improved more in the older subgroup, though the differences did not achieve statistical significance.
In addition, 42.86% of those aged 65 or older and 22.22% of those below 65 years reported minimal symptom expression after one month. After three months, these numbers increased to 100% of those aged 65 or older and 66.67% of those below 65 years.
Many patients in both age groups were also able to successfully lower their glucocorticoid dose over time. In fact, five individuals aged 65 and older discontinued glucocorticoids entirely after six months.
Levels of immunoglobulin G, M and A all decreased during treatment with telitacicept. Furthermore, levels of anti-acetylcholine receptor or muscle-specific tyrosine kinase — depending on the patient’s baseline antibody status — also declined.
Over the study period, three participants reported injection site reactions that resolved without any intervention. The investigators reported no other treatment-emergent adverse events.
“This study highlights the therapeutic potential of telitacicept in managing MG,” the authors concluded. “Future largescale, multicenter, prospective randomized controlled trials are needed to validate these findings and establish optimal dosing protocols.”
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