The diagnostic sensitivity of three laboratory tests [serum antiacetylcholine receptor antibody (AChR-ab) assay, the repetitive nerve stimulation (RNS) test, and, the single fiber EMG (SFEMG)] for myasthenia gravis (MG) was compared in 120 patients. In all cases, at least one of the tests was abnormal. SFEMG was the most sensitive test, being abnormal in 92% of cases, followed by the RNS test (77%) and the AChR-ab assay (73%). SFEMG was abnormal in all cases with negative AChR-ab and RNS tests, in 97% of cases with negative AChR-ab assay, in 89% of cases with negative RNS test, and in 89% of cases with mild MG. We conclude that one of these three tests is abnormal in all cases of MG, and that the SFEMG is most sensitive in the diagnosis of MG.
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Case report: Efgartigimod is a novel therapeutic option for ocular myasthenia gravis: a report of 2 cases.
Front Immunol
January 2025
Department of Neurology, The First Affiliated Hospital of China Medical University, Shenyang, China.
Introduction: Efgartigimod has been approved for the treatment of acetylcholine receptor antibodies-positive generalized myasthenia gravis (AChR-Ab+gMG), but its efficacy in patients with ocular myasthenia gravis (OMG) is not known.
Case Presentation: We describe 2 cases of patients with AChR-Ab+ OMG who showed unfavorable responses to corticosteroids and tacrolimus. Within 2 weeks of initiating efgartigimod, both patients showed rapid improvement and minimal symptom expression was achieved in weeks 3 to 4, which was maintained up to week 12.
Ravulizumab and Efgartigimod in Myasthenia Gravis: A Real-World Study.
Neurol Neuroimmunol Neuroinflamm
January 2025
From the Department of Neurology with Experimental Neurology (F.S., S.L., M.S., M.H., P.D., L.M.G., S.H., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin; Neuroscience Clinical Research Center (F.S., S.L., M.S., M.H., P.D., L.M.G., S.H., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin; Department of Neurology with Institute of Translational Neurology (C.D.F.S., M.B., C.W.K., L.K., H.W., J.D.L.), University Hospital Münster; Institute of Biometry and Clinical Epidemiology (A.A.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin; Center for Stroke Research Berlin (A.A., M.S., A.M.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Germany; Department of Immunology (K.L.), Hellenic Pasteur Institute; and 2nd Neurology Department (J.T.), School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Greece.
Background And Objectives: Biologics that target pathogenic antibodies (Abs) and their effector functions such as the complement inhibitor ravulizumab and the neonatal Fc receptor agonist efgartigimod have recently been approved for the treatment of acetylcholine receptor (AChR)-Ab-positive myasthenia gravis (MG), but comparative studies are lacking.
Methods: In a prospective, exploratory real-world study, we assessed clinical efficacy, safety, and biological effects of ravulizumab and efgartigimod treatment initiation. Myasthenia Gravis-Activities of Daily Living and Quantitative Myasthenia Gravis scores were used as clinical endpoints.
Risk-Benefit Analysis of Novel Treatments for Patients with Generalized Myasthenia Gravis.
Adv Ther
December 2024
GENESIS Department, University of Naples Federico II, Naples, Campania, Italy.
Article Synopsis
Interpretable machine learning models for predicting short-term prognosis in AChR-Ab+ generalized myasthenia gravis using clinical features and systemic inflammation index.
Front Neurol
October 2024
Department of Neurology, Nanjing Jiangbei Hospital, Nanjing, China.
Article Synopsis
- - Myasthenia Gravis (MG) is an autoimmune disease causing muscle weakness, primarily affecting patients with anti-acetylcholine receptor antibodies, necessitating better ways to predict treatment responses.
- - The study seeks to create and test a machine learning model that combines inflammation metrics and clinical data to predict the short-term treatment outcomes for patients with generalized MG after 6 months.
- - Results showed that about 28.7% of patients had poor outcomes, with 11 key predictors identified, and the extreme gradient boosting (XGBoost) model proving most effective in forecasting these outcomes.
Post-hoc analyses from the ADAPT clinical study demonstrate aggregate sustained benefit of Efgartigimod in generalized myasthenia gravis.
J Neurol Sci
November 2024
The University of North Carolina School of Medicine, Department of Neurology, Chapel Hill, NC, USA.
Objectives: This post-hoc analysis evaluates the long-term efficacy of efgartigimod versus placebo in adult patients with generalized myasthenia gravis (gMG) with acetylcholine-receptor autoantibodies (AChR-Ab+), based on data from the ADAPT RCT and its open-label extension ADAPT+.
Methods: Changes from baseline in Quantitative Myasthenia Gravis (QMG) and Myasthenia Gravis-Activities of Daily Living (MG-ADL) scores were assessed by treatment group over the ADAPT (up to 20 weeks) and ADAPT+ time horizon (extended to 64 weeks for efgartigimod group patients). Response to treatment was defined as 5-point reduction in QMG or 3-point reduction in MG-ADL vs.
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