[Pubmed] Assessment of Hospitalizations in Patients with Generalized Myasthenia Gravis (gMG) Before and During Treatment

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Neurology. 2025 Apr 8;104(7_Supplement_1):1832. doi: 10.1212/WNL.0000000000208772. Epub 2025 Apr 7.

ABSTRACT

OBJECTIVE: To assess rates and characteristics of hospitalizations among patients with anti-acetylcholine receptor antibody-positive (AChR-Ab+) gMG before and during ravulizumab treatment in clinical practice (MG SPOTLIGHT Registry; NCT04202341).

BACKGROUND: Studies comparing healthcare resource utilization in patients with gMG before and after complement component 5 inhibitor therapy (C5IT) are limited.

DESIGN/METHODS: Patients treated with ravulizumab (ravu-only subgroup) or switched from eculizumab to ravulizumab (ecu-to-ravu subgroup) with hospitalization data provided in case report forms were identified from the MG SPOTLIGHT Registry (data cutoff: 7/1/2024). Demographics and hospitalization (admission to ER, ICU, or healthcare facility) rates in the 12 months prior to and/or during ravulizumab treatment were analyzed. Primary reasons for hospitalizations were reported.

RESULTS: A total of 138 patients (male: 60.1%; White: 85.5%) were assessed; of these, 25/61 patients in the ravu-only subgroup and 42/77 in the ecu-to-ravu subgroup reported ≥1 hospitalization visit. For the ravu-only subgroup, the hospitalization rate decreased from 57.38/100 patient-years (PY) to 15.44/100PY during treatment. For the ecu-to-ravu subgroup, the rate decreased from 27.86/100PY during eculizumab treatment to 21.39/100PY during ravulizumab treatment. Prior to treatment, the primary reasons for visits were myasthenic crisis (ravu-only subgroup, 25.7%; ecu-to-ravu subgroup, 20.5%) or exacerbation (ravu-only subgroup, 45.7%; ecu-to-ravu subgroup, 31.3%); during treatment, most visits were for non-MG related reasons (ravu-only subgroup, 77.8%; ecu-to-ravu subgroup, 64.7%). Among patients with MG-related hospitalizations prior to ravulizumab treatment (n=50), 16 (32.0%) from the ravu-only subgroup and 24 (48.0%) from the ecu-to-ravu subgroup had ≥1 MG crisis or exacerbation. Among patients with MG-related hospitalizations during ravulizumab treatment (n=8), none reported crises or exacerbations.

CONCLUSIONS: These results show hospitalizations and MG crises/exacerbations among patients with gMG are reduced after ravulizumab treatment. Reductions in hospitalizations with ravulizumab were most pronounced in patients not previously treated with eculizumab, whereas the decrease in hospitalizations associated with eculizumab was maintained after switching to ravulizumab. Disclosure: Dr. Tandan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Tandan has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Apellis. Dr. Tandan has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Amylyx. The institution of Dr. Tandan has received research support from Alexion. The institution of Dr. Tandan has received research support from Apellis. The institution of Dr. Tandan has received research support from Cytokinetics. Dr. Macwan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Alexion,Argenx,Catalyst,Kabafusion, UCB. Dr. Macwan has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Abbvie,Alexion,Argenx,Biohaven,Catalyst,Grifols,Supernus. The institution of Dr. Macwan has received research support from Alexion, Disimmune Disease Foundation . Dr. Winkley has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for Biogen. Dr. Winkley has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Alexion. Dr. Winkley has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for Sanofi. Dr. Winkley has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Novartis. Dr. Winkley has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Serrono. Dr. Winkley has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Teva. Dr. Winkley has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche. Dr. Winkley has received personal compensation in the range of $100,000-$499,999 for serving on a Speakers Bureau for Biogen. Dr. Winkley has received personal compensation in the range of $100,000-$499,999 for serving on a Speakers Bureau for Sanofi. Dr. Winkley has received personal compensation in the range of $100,000-$499,999 for serving on a Speakers Bureau for Serrono. Dr. Winkley has received personal compensation in the range of $100,000-$499,999 for serving on a Speakers Bureau for Novartis. Dr. Winkley has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Roche. Dr. Winkley has received personal compensation in the range of $100,000-$499,999 for serving on a Speakers Bureau for Teva. Dr. Winkley has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Alexion. Dr. Winkley has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Allergan. Dr. Winkley has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for lilly. Dr. Winkley has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Pfizer. The institution of Dr. Winkley has received research support from Noveratis. The institution of Dr. Winkley has received research support from Merck. The institution of Dr. Winkley has received research support from Sanofi. The institution of Dr. Winkley has received research support from Biogen. The institution of Dr. Winkley has received research support from Alexion. Dr. Scheiner has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion Pharmaceuticals . Dr. Scheiner has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for CSL Behring . Dr. Scheiner has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Argenx Pharmaceuticals. Dr. Scheiner has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for CSL Behring . Dr. Scheiner has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Alexion Pharmaceuticals . The institution of Dr. Scheiner has received research support from Alexion Pharmaceuticals . Dr. Nicolle has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alexion. Dr. Nicolle has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Various legal firms. Dr. Zeinali has received personal compensation for serving as an employee of Alexion Pharmaceuticals, AstraZeneca Rare Disease. Dr. Zeinali has stock in AstraZeneca. Dr. Liu has received personal compensation for serving as an employee of Alexion. Dr. Cutter has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biodelivery Sciences International, Biogen, Click Therapeutics, Genzyme, Genentech, GW Pharmaceuticals, Immunic, Klein-Buendel Incorporated, Medimmune/Viela Bio, Medday, Merck/Serono, Neurogenesis LTD, Novartis, Osmotica Pharmaceuticals, Perception Neurosciences, Recursion/Cerexis Pharmaceuticals, Regeneron, Reckover Pharmaceuticals, Roche, TG Therapeutics.. Dr. Cutter has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Applied Therapeutics, AI therapeutics, AMO Pharma, Astra-Zeneca, Avexis Pharmaceuticals, Biolinerx, Brainstorm Cell Therapeutics, Bristol Meyers Squibb/Celgene, CSL Behring, Galmed Pharmaceuticals, Green Valley Pharma, Horizon Pharmaceuticals, Immunic, Karuna Therapeutics, Mapi Pharmaceuticals LTD, Merck, Mitsubishi Tanabe Pharma Holdings, Opko Biologics,Prothena Biosciences, Novartis, Regeneron, Sanofi-Aventis, Reata Pharmaceuticals, NHLBI (Protocol Review Committee), University of Texas Southwestern, University of Pennsylvania, Visioneering Technologies, Inc.. Dr. Cutter has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for JASN. Dr. Habib has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Alexion. Dr. Habib has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for argenx. Dr. Habib has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Immunovant. Dr. Habib has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for UCB. Dr. Habib has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Pfizer. Dr. Habib has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genentech/Roche. Dr. Habib has received personal compensation in the range of $500-$4,999 for serving as a Consultant for NMD Pharma. Dr. Habib has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alpine Immune Sciences. Dr. Habib has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Arcellx. Dr. Habib has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Horizon/ Amgen. Dr. Habib has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Grifols. Dr. Habib has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for NIH/NINDS. Dr. Habib has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Immunis Biomedical. Dr. Habib has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Hoffman-La Roche. Dr. Habib has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Alexion. Dr. Habib has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for argenx. Dr. Habib has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for UCB. The institution of Dr. Habib has received research support from Alexion. The institution of Dr. Habib has received research support from Horizon/Amgen. The institution of Dr. Habib has received research support from Immunovant. The institution of Dr. Habib has received research support from UCB. The institution of Dr. Habib has received research support from argenx. The institution of Dr. Habib has received research support from CabalettaBio. The institution of Dr. Habib has received research support from Genentech. The institution of Dr. Habib has received research support from Regeneron. Dr. Pulley has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alexion. Dr. Pulley has received personal compensation in the range of $500-$4,999 for serving as a Consultant for MT Pharma. Dr. Pulley has received personal compensation in the range of $500-$4,999 for serving as a Consultant for amylyx. Dr. Pulley has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amgen. Dr. Pulley has received personal compensation in the range of $500-$4,999 for serving as a Consultant for csl/behring. Dr. Pulley has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Cabaletta. Dr. Pulley has received personal compensation in the range of $50,000-$99,999 for serving as an Expert Witness for Multiple law firms. Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.

PMID:40194096 | DOI:10.1212/WNL.0000000000208772


Source: https://pubmed.ncbi.nlm.nih.gov/4019409 ... t9+e462414