[Pubmed] Advancements in Targeted Therapies for Generalized Acetylcholine Receptor Antibody Positive Myasthenia Gravis:
Posté : 14 août 2023 12:00
Eur J Neurol. 2023 Aug 14. doi: 10.1111/ene.16037. Online ahead of print.
ABSTRACT
In recent years, a new era of biologic therapeutics has emerged for the treatment of generalized myasthenia gravis (gMG). Compared to traditional immune modulatory therapies (steroids, non-steroidal immunosuppressive agents), these agents have more specific target engagement via inhibition of complement activation (eculizumab, ravulizumab, zilucoplan) or blockade of IgG recycling via the neonatal Fc receptor (FcRn; efgartigimod, rozanolixizumab). Phase 3 trials with each of these agents have shown rapid clinical improvement and good safety and tolerability. B-cell targeting with rituximab was safe and well-tolerated but with less impressive efficacy in two phase 2 studies. As a result, four new therapies are now approved for use (eculizumab, ravulizumab, efgartigimod, rozanolixizumab), another (zilucoplan) is in regulatory approval process and several others are in pivotal trials. A paradigm shift is afoot. The challenge is figuring out where these therapies may fit in gMG treatment algorithms.
PMID:37578121 | DOI:10.1111/ene.16037
Source: https://pubmed.ncbi.nlm.nih.gov/3757812 ... t6+86293ac