{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T01:11:08Z","timestamp":1792631468505,"version":"4.5.0"},"reference-count":10,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,9,11]],"date-time":"2023-09-11T00:00:00Z","timestamp":1694390400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction\/Aims<\/jats:title><jats:p>Multiple novel therapies have been approved for patients with myasthenia gravis. Our aim is to describe the early experience of efgartigimod use in acetylcholine receptor antibody\u2010positive generalized myasthenia gravis (AChR+ve gMG).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This multicenter retrospective study included AChR+ve gMG patients from five major neuromuscular centers who were treated with efgartigimod and had both pre\u2010 and post\u2010efgartigimod myasthenia gravis activities of daily living (MG\u2010ADL) scores. Information regarding MG history, concomitant treatment(s), MG\u2010ADL and other MG\u2010specific measures, laboratory data, and adverse events were recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 37 patients (M:23, F:14) with a mean age of 65.56 (\u00b114.74) y were included in this cohort. A total of 36\/37 patients completed at least one cycle and 28 patients completed at least two cycles of efgartigimod. A total of 72% (26\/36) of patients had a clinically meaningful reduction (\u22652 point change) in MG\u2010ADL after the completion of the first cycle of efgartigimod (mean pre\u2010efgartigimod 8.02) (\u00b13.09) versus post\u2010efgartigimod 4.33 (\u00b13.62). Twenty\u2010five percent (9\/36) achieved minimal symptom expression status after one cycle and 25% (7\/28) after the second cycle. Treatment benefit was sustained after cycle 2. Three out of four patients with thymoma in this cohort had clinically significant reductions in MG\u2010ADL scores. Immunoglobulin G (IgG) levels decreased by about 60% (<jats:italic>n<\/jats:italic>\u2009=\u200910). One patient had a relapse of <jats:italic>Clostridium difficile<\/jats:italic> infection resulting in the discontinuation of therapy. Four patients had mild side effects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Efgartigimod led to clinically meaningful improvement in MG\u2010ADL in diverse AChR+ve gMG patients but treatment frequency to achieve optimal symptom control needs to be explored.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mus.27974","type":"journal-article","created":{"date-parts":[[2023,9,11]],"date-time":"2023-09-11T14:24:58Z","timestamp":1694442298000},"page":"762-766","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Safety and outcomes with efgartigimod use for acetylcholine receptor\u2010positive generalized myasthenia gravis in clinical practice"],"prefix":"10.1002","volume":"68","author":[{"given":"Nakul","family":"Katyal","sequence":"first","affiliation":[{"name":"Department of Neurology and Neurosciences Stanford University  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Halldorsdottir","sequence":"additional","affiliation":[{"name":"Departments of Neurology University of California  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raghav","family":"Govindarajan","sequence":"additional","affiliation":[{"name":"HSHS St. Elizabeth Medical Group  O'Fallon Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7145-7663","authenticated-orcid":false,"given":"Perry","family":"Shieh","sequence":"additional","affiliation":[{"name":"Department of Neurology University of California, Los Angeles  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suraj","family":"Muley","sequence":"additional","affiliation":[{"name":"Bob Bove Neuroscience Institute at HonorHealth  Scottsdale Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phoebedel","family":"Reyes","sequence":"additional","affiliation":[{"name":"Department of Neurology University of California, Los Angeles  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth K.","family":"Leung","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurosciences Stanford University  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Mullen","sequence":"additional","affiliation":[{"name":"Departments of Neurology University of California  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shadi","family":"Milani\u2010Nejad","sequence":"additional","affiliation":[{"name":"Departments of Neurology University of California  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manisha","family":"Korb","sequence":"additional","affiliation":[{"name":"Departments of Neurology University of California  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Namita A.","family":"Goyal","sequence":"additional","affiliation":[{"name":"Departments of Neurology University of California  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tahseen","family":"Mozaffar","sequence":"additional","affiliation":[{"name":"Departments of Neurology University of California  Irvine California USA"},{"name":"Department of Pathology and Laboratory Medicine University of California  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neelam","family":"Goyal","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurosciences Stanford University  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3432-9747","authenticated-orcid":false,"given":"Ali A.","family":"Habib","sequence":"additional","affiliation":[{"name":"Departments of Neurology University of California  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2773-2506","authenticated-orcid":false,"given":"Srikanth","family":"Muppidi","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurosciences Stanford University  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,9,11]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/1750\u20101172\u20102\u201044"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474\u20104422(21)00159\u20109"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749\u20106632.2012.06817.x"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/CND.0000000000000156"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/S00415\u2010020\u201009770\u2010Y"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000011108"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(23)00080-7"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/EVIDoa2100066"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/CND.0000000000000443"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.23839"}],"container-title":["Muscle &amp; Nerve"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mus.27974","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,16]],"date-time":"2023-10-16T07:37:25Z","timestamp":1697441845000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/mus.27974"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,11]]},"references-count":10,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023,11]]}},"alternative-id":["10.1002\/mus.27974"],"URL":"https:\/\/doi.org\/10.1002\/mus.27974","archive":["Portico"],"relation":{},"ISSN":["0148-639X","1097-4598"],"issn-type":[{"value":"0148-639X","type":"print"},{"value":"1097-4598","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,11]]},"assertion":[{"value":"2023-04-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-23","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-09-11","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}