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Comparative Study
. 2024 Nov 18;14(1):28394.
doi: 10.1038/s41598-024-79918-7.

Efgartigimod versus intravenous immunoglobulin in the treatment of patients with impending myasthenic crisis

Jing Ma  1   2 , Huiqiu Zhang  1   2 , Junsen Zhao  1   2 , Menghan Su  1   2 , Yingna Feng  1 , Xiaoli Yuan  1 , Dan Liu  1 , Xiaomin Pang  1 , Rongjuan Zhao  1 , Juan Wang  1 , Weisong Duan  3 , Xueli Chang  1 , Junhong Guo  4 , Wei Zhang  5
Affiliations
Comparative Study

Efgartigimod versus intravenous immunoglobulin in the treatment of patients with impending myasthenic crisis

Jing Ma et al. Sci Rep. .

Abstract

Impending myasthenic crisis (IMC) is an emergent situation requiring aggressive management to prevent patients from developing myasthenic crisis (MC) in patients with myasthenia gravis (MG). Efgartigimod has been proved to be well tolerated and efficacious in MG patients. The present study aimed to compare the efficacy of efgartigimod and intravenous immunoglobulin (IVIg) in rescuing IMC. IMC patients treated with efgartigimod or IVIg were retrospectively enrolled. The primary outcome was determined as the mean change in MG activities of daily living (MG-ADL) score from baseline to week 1 and 4 after treatment, respectively. Safety was assessed based on medical records during the hospitalization to monitor the adverse events. A total of 9 patients treated with efgartigimod and 10 patients treated with IVIg were enrolled. There were no significant differences in the clinical characteristics at baseline between the two groups (P > 0.05). Compared with the IVIg group, the efgartigimod group had a greater reduction in the MG-ADL score at week 1 (P = 0.035) and week 4 (P = 0.005). One patient in the efgartigimod group had an upper respiratory infection. These findings suggest that efgartigimod is a treatment option for IMC in addition to IVIg and plasma exchange.

Keywords: Efficacy; Efgartigimod; IVIg; Impending myasthenic crisis; Myasthenia gravis.

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Conflict of interest statement

Declarations Competing interests The authors declare no competing interests. Consent for publication All authors agreed with the content of the manuscript, and all patients or legal guardians consented to the publication. Ethical approval We confirm that we have read the Journal’s position on issues involved in ethical publication and affirm that this report is consistent with those guidelines.

Figures

Fig. 1
Fig. 1
The workflow for enrollment in both treatment groups. MG, myasthenia gravis; MC, myasthenic crisis; IMC, impending myasthenic crisis; MGFA, Myasthenia Gravis Foundation of America Classification.
Fig. 2
Fig. 2
The changes in the MG-ADL score (A), MGC score (B), QMG score (C) and MG-QOL15r score (D) in the efgartigimod group during the follow-up compared with baseline. MG-ADL, Myasthenia Gravis Activities of Daily Living; MGC, Myasthenia Gravis Composite scale; QMG, quantitative Myasthenia Gravis; MG-QOL15r, the revised 15-item Myasthenia Gravis Quality of Life questionnaire. Error bars show standard error. * P < 0.05, ** P < 0.01, *** P < 0.001, ns, not significant.
Fig. 3
Fig. 3
The comparisons of changes in the MG-ADL score (A) and MGC score (B) at week 1 and week 4 after treatment between the two groups. MG-ADL, Myasthenia Gravis Activities of Daily Living; MGC, Myasthenia Gravis Composite scale. Error bars show standard error. * P < 0.05, ** P < 0.01, ns, not significant.
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