TY - JOUR Y1 - 2025/01/11/ N2 - Background: We report our experience of patients with generalised myasthenia gravis (gMG) treated with efgartigimod, an neonatal Fc receptor antagonist, under the Early Access to Medicine Scheme (EAMS) in the UK. Methods: Data from all UK patients treated with efgartigimod under the EAMS July 2022 to July 2023 were collected retrospectively. Efgartigimod was administered as per the ADAPT protocol (consisting of a treatment cycle of four infusions at weekly intervals with further cycles given according to clinical need). Results: 48 patients with acetylcholine receptor antibody-positive gMG were treated in 12 centres. Most (75%) were female and most had a disease duration of over 10 years. The average MG-Activities of Daily Living (ADL) score at baseline was 11.2. Most (72.9%) patients had undergone thymectomy. 77.0% were taking prednisolone at baseline. All patients had used non-steroidal immunosuppressant treatments, the average number tried was 2.6 (range 1-6). 51% had received rituximab. 54.2% of patients required regular intravenous immunoglobulin/plasma exchange. 75% of patients had a mean reduction in the MG-ADL of?2 points in the first cycle and this remained stable throughout the study. The mean intracycle reduction in the MG-ADL score in the first, second, third and fourth cycles were -4.6 to -3.9, -3.4 and -4.2, respectively. Side effects were generally mild. No rescue treatments were required. At the end of the study, 96% of patients remained on efgartigimod. Conclusion: Efgartigimod is a safe and effective treatment for patients with refractory, treatment-resistant gMG. JF - Journal of Neurology, Neurosurgery and Psychiatry N1 - This version is the author accepted manuscript. For information on re-use, please refer to the publisher?s terms and conditions. VL - 96 ID - discovery10206623 UR - https://doi.org/10.1136/jnnp-2024-334086 PB - BMJ Publishing Group TI - Efgartigimod efficacy and safety in refractory myasthenia gravis: UK's first real-world experience AV - public A1 - Dionisio, Joana Moniz A1 - Ambrose, Philip A1 - Burke, Georgina A1 - Farrugia, Maria Elena A1 - Garcia-Reitboeck, Pablo A1 - Hewamadduma, Channa A1 - Hill, Marguerite A1 - Howard, Robin S A1 - Jacob, Saiju A1 - Kullmann, Dimitri A1 - Leite, Maria Isabel A1 - Miller, James A1 - Pinto, Ashwin A1 - Pritchard, Jane A1 - Riswick, Thomas A1 - Sathasivam, Sivakumar A1 - Thambirajah, Narmathey A1 - Viegas, Stuart A1 - Norwood, Fiona A1 - Spillane, Jennifer SP - 322 SN - 0022-3050 EP - 328 KW - Clinical Neurology KW - FC RECEPTOR KW - Life Sciences & Biomedicine KW - MYASTHENIA KW - NEUROMUSCULAR KW - Neurosciences & Neurology KW - Psychiatry KW - Science & Technology KW - Surgery IS - 4 ER -