Real-world Treatment Patterns Among Patients with Generalized Myasthenia Gravis (P6-11.027)
Recommended Citation
Grover K, Gandhi K, Cloutier M, Coteur G, Zhdanava M, El Khoury AC, Boonmak P, Cai Q, Tardif-Samson A, Ait-Tihyaty M, Wang Y, Choudhry Z, Silvestri NJ. Real-world Treatment Patterns Among Patients with Generalized Myasthenia Gravis (P6-11.027). Neurology 2025; 104(7_Supplement_1).
Document Type
Conference Proceeding
Publication Date
4-8-2025
Publication Title
Neurology
Abstract
Objective: To evaluate real-world treatment patterns and myasthenia gravis (MG)-related clinical events among patients with generalized MG (gMG) in the US. Background: gMG is a rare chronic autoimmune condition. Conventional treatments include acetylcholinesterase inhibitors (AChEI), corticosteroids, and non-steroidal immunosuppressants. Newly approved targeted therapies include neonatal Fc receptor (FcRn) and complement-5 (C5) inhibitors. Knowledge of real-world treatment patterns with currently available therapies and MG-related clinical events is limited. Design/Methods: Adults with gMG were identified from the Komodo Research Database (01/2017-09/2023). Index date was the first MG diagnosis by a neurologist. Baseline (12-months pre-index) demographic characteristics, follow-up (≥12 months post-index) treatment patterns, including first 5 observed treatment episodes, MG exacerbations and crises were described. Results: 6,195 patients were included (mean age: 61.1 years; female: 49.1%; mean follow-up: 32.7 months). Among those receiving treatments, from the first episode (n=5,652) to the fifth episode (n=2,107): AChEI use declined from 81.1% to 58.5%; corticosteroid use fluctuated between 48.2-63.2%, and use of the following treatments increased: any non-steroidal immunosuppressants (11.8% to 41.8%), any immunoglobulin (6.3% to 15.6%), FcRn inhibitors (0.1% to 2.7%), and C5 inhibitors (0.2% to 2.9%). Mean time from index date to FcRn initiation was 20.7 months and to C5 inhibitors initiation 15.8 months. Post-index, 48.8% and 3.1% of patients had MG exacerbation or crisis, respectively. Exacerbations and crises were most common 1-year post-index (41.5%), but declined over time (20.3%, 18.0%, and 14.4% in the second, third, and fourth year, respectively). Conclusions: Conventional treatments were an initial treatment strategy for most patients in this cohort, while immunoglobulin and targeted treatments were generally used later. This, combined with the high rates of exacerbation and crisis during the first year, highlights an unmet need for treatment strategies that provide stable and sustained disease control earlier in the disease course when managing patients with gMG.
Volume
104
Issue
7_Supplement_1
