{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T15:03:23Z","timestamp":1784127803412,"version":"3.55.0"},"reference-count":49,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T00:00:00Z","timestamp":1781827200000},"content-version":"vor","delay-in-days":18,"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"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82171399"],"award-info":[{"award-number":["82171399"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82371413"],"award-info":[{"award-number":["82371413"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82571597"],"award-info":[{"award-number":["82571597"]}],"id":[{"id":"10.13039\/501100001809","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":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To compare the real\u2010world effectiveness, surgical and economic outcomes of preoperative rapid antibody clearance therapy (RACT:\u00a0lymphoplasmapheresis (LPE), efgartigimod (EFG)) versus oral immunosuppressants (Oral IS) in generalized myasthenia gravis (gMG) patients undergoing thymectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study included 78 patients (36 Oral IS, 42 RACT: 25 LPE, 17 EFG). Primary outcome: 3\u2010month postoperative quantitative myasthenia gravis (QMG) score. Secondary outcomes: 1\u2010month postoperative exacerbation rate, 3\u2010 and 6\u2010month MG activities of daily living (MG\u2010ADL), 6\u2010month QMG, surgical outcomes (operative time, blood loss, postoperative myasthenic crisis (POMC)), perioperative costs (pre\u2010 and post\u2010reimbursement). Propensity score overlap weighting balanced covariates. Sensitivity analyses used propensity matching; multiple imputation handled missing data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After weighting, 3\u2010month QMG scores showed no significant difference between RACT and Oral IS groups (mean difference (MD) \u22120.23, 95% CI: \u22122.99 to 2.54,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.831) nor between the EFG and LPE subgroups (MD 1.15, 95% CI: \u22123.97 to 6.26,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.567); similar for MG\u2010ADL. All groups improved over time (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). For EFG vs. LPE, 1\u2010month exacerbation rate was 43.3% vs. 26.1% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.412). No significant between\u2010group differences between EFG and LPE were found in 6\u2010month QMG\/MG\u2010ADL scores and surgical outcomes. EFG had higher preoperative pre\u2010reimbursement costs (MD 14,500 CNY,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.026), but no cost differences remained after insurance. Sensitivity analyses confirmed robustness of the primary findings.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Preoperative RACT effectively reduced QMG in gMG patients, with no significant postoperative medium\u2010term effectiveness and safety differences between RACT and Oral IS. Similarly, no significant differences in postoperative medium\u2010term effectiveness, safety, or post\u2010reimbursement costs were observed between EFG and LPE.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cns.70993","type":"journal-article","created":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T05:40:35Z","timestamp":1781934035000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efgartigimod Versus Lymphoplasmapheresis as Preoperative Rapid Antibody\u2010Clearing Therapies for Thymectomy in Generalized Myasthenia Gravis: Effectiveness, Safety and Cost Outcomes Compared to Conventional Preparation"],"prefix":"10.1002","volume":"32","author":[{"given":"Qian","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Neurology, Xiangya Hospital Central South University  Changsha Hunan People's Republic of China"},{"name":"Clinical Research Center for Neuroimmune and Neuromuscular 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Hospital, National Clinical Research Center for Geriatric Disorders Central South University  Changsha People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6072-6611","authenticated-orcid":false,"given":"Kangzhi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Xiangya Hospital Central South University  Changsha Hunan People's Republic of China"},{"name":"Department of Neurology and Immunobiology Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuzhen","family":"Ouyang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Xiangya Hospital Central South University  Changsha Hunan People's Republic of China"},{"name":"Clinical Research Center for Neuroimmune and Neuromuscular Disorders, Xiangya Hospital Central South University  Changsha Hunan People's Republic of China"},{"name":"National 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