{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:19:20Z","timestamp":1791389960875,"version":"4.3.3"},"reference-count":35,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,10,14]],"date-time":"2021-10-14T00:00:00Z","timestamp":1634169600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006396","name":"Alexion Pharmaceuticals","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006396","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction\/Aims<\/jats:title><jats:p>Individuals with refractory generalized myasthenia gravis (gMG) who have a history of rituximab use and experience persistent symptoms represent a population with unmet treatment needs. The aim of this analysis was to evaluate the efficacy and safety of eculizumab in patients with refractory anti\u2010acetylcholine receptor antibody\u2010positive (AChR<jats:sup>+<\/jats:sup>) gMG previously treated with rituximab.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This <jats:italic>post hoc<\/jats:italic> subgroup analysis of the phase 3 REGAIN study (NCT01997229) and its open\u2010label extension (OLE; NCT02301624) compared baseline characteristics, safety, and response to eculizumab in participants who had previously received rituximab with those who had not. Rituximab use was not permitted within the 6\u2009months before screening or during REGAIN\/OLE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 125 REGAIN participants, 14 had received rituximab previously (7 received placebo and 7 received eculizumab). In the previous\u2010rituximab group, 57% had used at least four other immunosuppressants compared with 16% in the no\u2010previous\u2010rituximab group. Myasthenia Gravis Activities of Daily Living total scores from eculizumab baseline to week 130 of eculizumab treatment improved in both the previous\u2010rituximab and no\u2010previous\u2010rituximab groups (least\u2010squares mean \u22124.4, standard error of the mean [SEM] 1.0 [n\u00a0=\u00a09] and least\u2010squares mean \u22124.6, SEM 0.3 [n\u00a0=\u00a067], respectively; difference\u00a0=\u00a00.2, 95% confidence interval \u22121.88 to 2.22). In addition, in both groups, most patients who were treated with eculizumab for 130\u2009weeks achieved a Myasthenia Gravis Foundation of America post\u2010intervention status of minimal manifestations (66.7% and 65.0%, respectively). The eculizumab safety profile was similar between groups and consistent with its established profile.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Eculizumab is an effective therapy for patients with refractory AChR<jats:sup>+<\/jats:sup> gMG, irrespective of whether they had received rituximab treatment previously.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mus.27422","type":"journal-article","created":{"date-parts":[[2021,9,30]],"date-time":"2021-09-30T16:42:08Z","timestamp":1633020128000},"page":"662-669","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Eculizumab in refractory generalized myasthenia gravis previously treated with rituximab: subgroup analysis of <scp>REGAIN<\/scp> and its extension study"],"prefix":"10.1002","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2421-8381","authenticated-orcid":false,"given":"Zaeem A.","family":"Siddiqi","sequence":"first","affiliation":[{"name":"Division of Neurology, Department of Medicine University of Alberta  Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard J.","family":"Nowak","sequence":"additional","affiliation":[{"name":"Department of Neurology Yale University School of Medicine, Yale University  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tahseen","family":"Mozaffar","sequence":"additional","affiliation":[{"name":"Department of Neurology University of California Irvine  Orange California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fanny","family":"O'Brien","sequence":"additional","affiliation":[{"name":"Alexion Pharmaceuticals, Inc.  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus","family":"Yountz","sequence":"additional","affiliation":[{"name":"Alexion Pharmaceuticals, Inc.  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Patti","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences and Advanced Technologies G.F. Ingrassia, University of Catania  Catania Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the REGAIN Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,10,14]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.26.11.1054"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02337460"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.880150616"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.56.5.496"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1254.036"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.48.12.1246"},{"issue":"2","key":"e_1_2_11_8_1","first-page":"255","article-title":"Clinical characteristics of refractory myasthenia gravis patients","volume":"86","author":"Suh J","year":"2013","journal-title":"Yale J Biol Med"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/CND.0000000000000034"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000002790"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000011124"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-014-7532-3"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000000498"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmd.2016.12.004"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/acn3.314"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.26156"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/acn3.564"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2019-322606"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000004341"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jneuroim.2017.05.021"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.3233\/JND-180300"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.25597"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2020.0851"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000005692"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.2147\/ITT.S261414"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1038\/nbt1344"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.26447"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(17)30369-1"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000011207"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-020-09770-y"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1900866"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2012.04252.x"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa061648"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2014.423"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1208981"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.15790"}],"container-title":["Muscle &amp; 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