Oral GC Dose Tapering & Efgartigimod Initiation – MG Link
Summary of Efgartigimod treatment Effects in generalized Myasthenia Gravis (gMG)
This text details the positive effects observed in patients with generalized Myasthenia Gravis (gMG) after initiating treatment with efgartigimod. Here’s a breakdown of the key findings:
1. Reduction in Use of Other Immunotherapies:
Meaningful decreases were observed in the use of other immunosuppressants after starting efgartigimod:
Acetylcholinesterase inhibitors: 85% too 80%
Non-Steroidal Immunosuppressive Therapy (NSIST): 60% to 55%
Intravenous/Subcutaneous Immunoglobulin: 35% to 5%
Plasma Exchange: 9% to 3%
77% of patients had prior exposure to NSIST.
2. Decreased Polytherapy:
The number of drug classes prescribed to patients decreased over time:
Before Efgartigimod: 16% used 4+ drug classes,39% used 3,32% used 2,13% used 1,and 0% received no treatment.
After 12 Months: 1% used 4+ drug classes, 20% used 3, 46% used 2, 25% used 1, and 8% received no treatment.
3. Glucocorticoid Dose reduction:
Average daily glucocorticoid dose consistently decreased over 12 months:
Baseline: 17.9 mg/day
3 Months: 14.3 mg/day
6 Months: 13.4 mg/day
9 Months: 11.6 mg/day
12 Months: 10.2 mg/day
Significant proportion of patients reduced glucocorticoid use:
26% reported no glucocorticoid use at 1 year.
51% reduced their daily dose by at least 75%. 66% reduced their dose by at least 1 mg/day.
83% of patients starting on >30mg/day of glucocorticoids were able to taper their dose.Women were more likely to achieve this (82% increased likelihood). Higher baseline doses (>10mg/day) were also associated with greater success in tapering.4. Improved Myasthenia Gravis Activities of Daily Living (MG-ADL) Scores:
MG-ADL scores considerably improved, indicating better functional ability:
Baseline: 7.9
* 12 Months: 4.3 (P < .05)
Critically important Note: The study is observational,meaning it doesn’t have the strict controls of a clinical trial. However, the authors beleive the findings are meaningful and align with emerging clinical practice observations.