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Complement inhibitors and FcRn antagonists for myasthenia gravis

Despite existing symptomatic, immunomodulatory, and immunosuppressive therapies, significant unmet needs in myasthenia gravis (MG) treatment remain. Advances in drug development have seen the emergence of novel agents, such as complement inhibitors and neonatal Fc receptor (FcRn) antagonists, that can offer a more targeted and effective therapy with rapid treatment response and fewer side effects. Efgartigimod is an FcRn inhibitor recently approved for MG treatment, and other agents are in clinical trial development. Zilucoplan and ravulizumab are newer agents that belong to the class of complement inhibitors currently in clinical trials. With a growing list of new therapeutic options, treatment selection and approaches will be crucial in optimizing patient care.

In this episode, James F. Howard, Jr., MD, FAAN, University of North Carolina School of Medicine, Chapel Hill, NC, discusses the results from the open-label extensions of the CHAMPION MG trial (NCT03920293) of ravulizumab and of the ADAPT trial (NCT03770403) that served as a basis for the FDA approval of efgartigimod. The current and future role of complement inhibitor therapy and the knowledge gaps that need to be addressed to optimize the management of myasthenia gravis are also discussed.

Date: 19th August 2022