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Neuromuscul Disord. 2026 Aug 21;67:107398. doi: 10.1016/j.nmd.2026.107398. Online ahead of print.

ABSTRACT

Comparative evidence between efgartigimod and intravenous immunoglobulin (IVIg) in generalized myasthenia gravis (gMG) remains limited, especially regarding outcomes beyond the first month. We evaluated the 6-month efficacy and safety of single-cycle intravenous efgartigimod versus IVIg in 51 patients with moderate-to-severe gMG (efgartigimod: 26; IVIg: 25) receiving concomitant immunosuppressive therapy in a real-world setting. At month 1, significantly more efgartigimod-treated patients achieved the primary endpoint of minimal symptom expression (MSE) without intensive immunotherapy (42.3% vs. 12.0%; P = 0.023). Efgartigimod also demonstrated greater reductions in MG Activities of Daily Living scores at month 1 compared with IVIg (adjusted mean difference, -2.37; 95% CI, -3.99 to -0.74; P = 0.004). The median time to MSE was significantly shorter in the efgartigimod group (2.1 vs. 5.9 months; Breslow P = 0.030). However, clinical differences became non-significant at months 3 and 6. Rates of disease relapse or exacerbation remained comparable between groups. Both treatments were well tolerated. In conclusion, single-cycle intravenous efgartigimod was associated with faster early clinical improvement compared with IVIg, while outcomes were comparable at months 3 and 6 in the context of real-world immunosuppressive therapies. These findings suggest that efgartigimod may represent an alternative therapeutic option for patients with gMG requiring rapid symptom control.

PMID:42710422 | DOI:10.1016/j.nmd.2026.107398


Source: https://pubmed.ncbi.nlm.nih.gov/4271042 ... 2&v=2.20.1