{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T17:44:55Z","timestamp":1779126295550,"version":"3.51.4"},"reference-count":20,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T00:00:00Z","timestamp":1773619200000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82301527"],"award-info":[{"award-number":["82301527"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100019978","name":"Shanghai Pudong New Area Health Commission","doi-asserted-by":"publisher","award":["PWRq2025\u201023"],"award-info":[{"award-number":["PWRq2025\u201023"]}],"id":[{"id":"10.13039\/501100019978","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100019978","name":"Shanghai Pudong New Area Health Commission","doi-asserted-by":"publisher","award":["PW2022E\u201001"],"award-info":[{"award-number":["PW2022E\u201001"]}],"id":[{"id":"10.13039\/501100019978","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100019978","name":"Shanghai Pudong New Area Health Commission","doi-asserted-by":"publisher","award":["2024\u2010PWXZ\u201016"],"award-info":[{"award-number":["2024\u2010PWXZ\u201016"]}],"id":[{"id":"10.13039\/501100019978","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004921","name":"Shanghai Jiao Tong University","doi-asserted-by":"publisher","award":["YG2023LC04"],"award-info":[{"award-number":["YG2023LC04"]}],"id":[{"id":"10.13039\/501100004921","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["CNS Neurosci Ther"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Double\u2010Filtration plasmapheresis (DFPP) and efgartigimod (EFG) are both effective acute exacerbation therapies for generalized myasthenia gravis (gMG), yet real\u2010world comparative evidence remains limited. This study aims to systematically compare their clinical efficacy and safety to guide individualized treatment strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective multicenter study (Aug 2019\u2013Mar 2025) evaluated gMG patients treated with a cycle of DFPP (3\u20135 sessions) or EFG (4 weekly infusions). Primary endpoints included changes in Quantitative Myasthenia Gravis (QMG) and Myasthenia Gravis Activities of Daily Living (MG\u2010ADL) scores from baseline (T0) to post\u2010treatment (T1) and 1\u2009month after T1 (T2). Secondary endpoints covered clinical meaningful improvement (CMI), deep improvement rates (defined as \u2265\u20095\u2010point reduction in MG\u2010ADL or \u2265\u20099\u2010point in QMG), immunological changes, and safety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 66 MG patients (EFG\u2009=\u200941, DFPP\u2009=\u200925), both DFPP and EFG significantly reduced QMG and MG\u2010ADL scores at T1 and T2. In moderate\u2010to\u2010severe gMG (MGFA\u2009\u2265\u2009IIb), 3\/5\u2010session DFPP was superior to 4\u2010infusion EFG at T2 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05), while efficacy was comparable in mild cases (MGFA\u2009\u2264\u2009IIa). Sustained CMI rates (through T2) increased with higher treatment intensity; the 5\u2010session DFPP rate was significantly higher than the 3\u2010session DFPP (85% vs. 45%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.049) and numerically higher than the 4\u2010infusion EFG (85% vs. 70%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.413). The proportion of patients achieving deep improvement in 5\u2010session DFPP was higher than 4\u2010infusion EFG. DFPP broadly reduced immunoglobulins\/complement versus EFG's selective immunoglobulin G (IgG) reduction. Adverse events occurred in 28.0% of the DFPP group (mainly catheter\u2010related thrombosis) and 39.0% of the EFG group (predominantly headache;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.431), with no serious events reported.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Both DFPP and EFG effectively treat gMG, though DFPP offers greater benefit in moderate\u2010to\u2010severe cases, underscoring the need for individualized therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cns.70838","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T14:22:01Z","timestamp":1773670921000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Double\u2010Filtration Plasmapheresis Versus Efgartigimod for Generalized Myasthenia Gravis: Severity\u2010Stratified Benefits in a Prospective Observational Multicenter Study"],"prefix":"10.1002","volume":"32","author":[{"given":"Kan","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Neurology, Renji Hospital, School of Medicine Shanghai Jiao Tong University  Shanghai China"},{"name":"Department of Neurology Punan Branch of Renji Hospital, School of Medicine, Shanghai Jiao Tong University (Punan Hospital in Pudong New District, Shanghai)  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanyu","family":"Xin","sequence":"additional","affiliation":[{"name":"Department of Neurology Punan Branch of Renji Hospital, School of Medicine, Shanghai Jiao Tong University (Punan Hospital in Pudong New District, Shanghai)  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mengze","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Renji Hospital, School of Medicine Shanghai Jiao Tong University  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiuju","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology Punan Branch of Renji Hospital, School of Medicine, Shanghai Jiao Tong University (Punan Hospital in Pudong New District, Shanghai)  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanan","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Neurology Anhui No. 2 Provincial People's Hospital  Hefei China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xia","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology Anhui No. 2 Provincial People's Hospital  Hefei China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Neurology, Renji Hospital, School of Medicine Shanghai Jiao Tong University  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chong","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Neurology, Renji Hospital, School of Medicine Shanghai Jiao Tong University  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiajun","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Neurology, Renji Hospital, School of Medicine Shanghai Jiao Tong University  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Neurology, Renji Hospital, School of Medicine Shanghai Jiao Tong University  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xuzhong","family":"Pei","sequence":"additional","affiliation":[{"name":"Department of Neurology Punan Branch of Renji Hospital, School of Medicine, Shanghai Jiao Tong University (Punan Hospital in Pudong New District, Shanghai)  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yiwei","family":"Yang","sequence":"additional","affiliation":[{"name":"Hangzhou Dian Medical Laboratory Co., Ltd.  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