{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:27:38Z","timestamp":1790814458609,"version":"4.1.0"},"reference-count":46,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Myasthenia gravis (MG) is an autoimmune disorder that causes muscle weakness due to disrupted neuromuscular transmission. This network meta\u2010analysis compared the safety and effectiveness of monoclonal antibodies used to treat MG.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      PubMed, Cochrane Central, and ScienceDirect were searched through June 2025. A frequentist network meta\u2010analysis was conducted using the \u201cmeta\u201d and \u201cnetmeta\u201d packages in RStudio version 4.3.3. Treatment rankings were determined by\n                      <jats:italic>p<\/jats:italic>\n                      \u2010scores.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eighteen randomized controlled trials (RCTs) were included in this network meta\u2010analysis. Rozanolixzumab (ROZ) 10\u00a0mg\/kg significantly decreased the MG Activities of Daily Living (MG\u2010ADL) score compared to placebo (MD = \u22122.33; 95%CI:[\u20103.60, \u22121.06];\n                      <jats:italic>p<\/jats:italic>\n                      = 0.0003) and was ranked best (\n                      <jats:italic>p<\/jats:italic>\n                      \u2010score = 0.77) regarding this outcome. Batoclimab (BAT) 680\u00a0mg significantly reduced the Quantitative MG (QMG) score compared to placebo (MD = \u20105.17; 95%CI:[\u20106.44, \u20103.89]; p &lt;0.0001) and was rated the top performer (\n                      <jats:italic>p<\/jats:italic>\n                      \u2010score = 0.96) for this endpoint. Regarding the MG Composite (MGC) score, BAT 340\u00a0mg was ranked best (\n                      <jats:italic>p<\/jats:italic>\n                      \u2010score = 0.82), although the decrease in MGC score was insignificant (MD \u22125.30; 95%CI:[\u221211.01, 0.41];\n                      <jats:italic>p<\/jats:italic>\n                      = 0.07). Eculizumab (ECU) was ranked best (\n                      <jats:italic>p<\/jats:italic>\n                      \u2010score = 0.93) regarding the 15\u2010item revised MG Quality of Life (MG\u2010QoL 15r) score. Belimumab (BEL) 10\u00a0mg\/kg was ranked best regarding the adverse events (\n                      <jats:italic>p<\/jats:italic>\n                      \u2010score = 0.87).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ROZ 10\u00a0mg\/kg ranked best for MG\u2010ADL. BAT 680\u00a0mg significantly reduced QMG and ranked best. BAT 340\u00a0mg had the highest probability of reducing the MGC score. ECU significantly decreased MG\u2010QoL 15r and ranked best. BEL 10\u00a0mg\/kg had the highest likelihood of reducing adverse events.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/brb3.71557","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T05:31:32Z","timestamp":1781674292000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparing Efficacy and Safety of Various Monoclonal Antibodies in Myasthenia Gravis: A Systematic Review and Network Meta\u2010Analysis of Randomized Controlled Trials"],"prefix":"10.1002","volume":"16","author":[{"given":"Muhammad Hassan","family":"Waseem","sequence":"first","affiliation":[{"name":"Allama Iqbal Medical College  Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8990-7738","authenticated-orcid":false,"given":"Zain ul","family":"Abideen","sequence":"additional","affiliation":[{"name":"King Edward Medical University  Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minahil","family":"Iqbal","sequence":"additional","affiliation":[{"name":"Allama Iqbal Medical College  Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2005-9059","authenticated-orcid":false,"given":"Saniya","family":"Ishtiaq","sequence":"additional","affiliation":[{"name":"Rawalpindi Medical University  Rawalpindi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2085-8739","authenticated-orcid":false,"given":"Pawan Kumar","family":"Thada","sequence":"additional","affiliation":[{"name":"Sotang Primary Hospital  Solukhumbu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam A.","family":"Dmytriw","sequence":"additional","affiliation":[{"name":"Neuroendovascular Program, Massachusetts General Hospital &amp; Brigham and Women's Hospital Harvard Medical School  Boston Massachusetts USA"},{"name":"Neurointerventional &amp; Neuroanalytics Collaboration (NAN\u2010C), School of Medicine Toronto Metropolitan University  Toronto Canada"},{"name":"Nuffield Department of Surgical Sciences, Medical Sciences Division University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,16]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000207937"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(24)00498-8"},{"key":"e_1_2_13_4_1","unstructured":"Barohn R. J andL.Herbelin.2025. \u201cThe Quantitative Myasthenia Gravis (QMG) Test: the Manual.\" Myasthenia Gravis Foundation of America (2000).\u201d Cited 2025 Aug 19.https:\/\/scholar.google.com\/scholar?hl=en&as_sdt=0%2C5&q=Barohn+RJ.+The+Quantitative+Myasthenia+Gravis+%28QMG%29+Test%3A+the++Manual.+Myasthenia+Gravis+Foundation+of+America&btnG=."},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000011108"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(23)00077-7"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181dc1b1e"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.25198"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2377-10-46"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41582-018-0110-z"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199406233302507"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-019-0079-y"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(15)00145-3"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2023.11.013"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12967-024-05751-1"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13311-015-0398-y"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/17562864241273036"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(24)00514-3"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ncl.2018.01.002"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000005323"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781119536604"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(23)00080-7"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000007600"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(21)00159-9"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2019.5125"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(17)30369-1"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-023-01933-1"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-024-12247-x"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1177\/1756285617749134"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000011124"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2501561"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000013121"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-011-6194-7"},{"key":"e_1_2_13_35_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2022.2887"},{"key":"e_1_2_13_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.2006.01382.x"},{"key":"e_1_2_13_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.15872"},{"key":"e_1_2_13_38_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2024.1486659"},{"key":"e_1_2_13_39_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898"},{"key":"e_1_2_13_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.70158"},{"key":"e_1_2_13_41_1","doi-asserted-by":"publisher","DOI":"10.1056\/EVIDoa2100066"},{"key":"e_1_2_13_42_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-14-135"},{"key":"e_1_2_13_43_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000025899"},{"key":"e_1_2_13_44_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.52.7.1487"},{"key":"e_1_2_13_45_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40120-022-00345-9"},{"key":"e_1_2_13_46_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2024.0044"},{"key":"e_1_2_13_47_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-024-07460-5"}],"container-title":["Brain and Behavior"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/brb3.71557","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/brb3.71557","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/brb3.71557","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T20:30:56Z","timestamp":1782937856000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/brb3.71557"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":46,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1002\/brb3.71557"],"URL":"https:\/\/doi.org\/10.1002\/brb3.71557","archive":["Portico"],"relation":{},"ISSN":["2162-3279","2162-3279"],"issn-type":[{"value":"2162-3279","type":"print"},{"value":"2162-3279","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6]]},"assertion":[{"value":"2026-06-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e71557"}}