Dionisio, Joana Moniz;
              
      
            
                Ambrose, Philip;
              
      
            
                Burke, Georgina;
              
      
            
                Farrugia, Maria Elena;
              
      
            
                Garcia-Reitboeck, Pablo;
              
      
            
                Hewamadduma, Channa;
              
      
            
                Hill, Marguerite;
              
      
            
            
          
      
            
            
          
      
            
            
          
      
            
            
          
      
            
            
          
      
            
            
          
      
            
            
          
      
            
            
          
      
            
            
          
      
            
            
          
      
            
            
          
      
            
            
          
      
            
            
            ... Spillane, Jennifer; + view all
            
          
      
        
        
        
    
  
(2025)
  Efgartigimod efficacy and safety in refractory myasthenia gravis: UK's first real-world experience.
Journal of Neurology, Neurosurgery and Psychiatry
, 96
       (4)
    
     pp. 322-328.
    
         10.1136/jnnp-2024-334086.
  
  
      
    
  
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Abstract
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.
| Type: | Article | 
|---|---|
| Title: | Efgartigimod efficacy and safety in refractory myasthenia gravis: UK's first real-world experience | 
| Location: | England | 
| Open access status: | An open access version is available from UCL Discovery | 
| DOI: | 10.1136/jnnp-2024-334086 | 
| Publisher version: | https://doi.org/10.1136/jnnp-2024-334086 | 
| Language: | English | 
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. | 
| Keywords: | Clinical Neurology, FC RECEPTOR, Life Sciences & Biomedicine, MYASTHENIA, NEUROMUSCULAR, Neurosciences & Neurology, Psychiatry, Science & Technology, Surgery | 
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Clinical and Experimental Epilepsy  | 
        
| URI: | https://discovery.ucl.ac.uk/id/eprint/10206623 | 
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