{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T03:58:38Z","timestamp":1790135918586,"version":"4.0.1"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,11,7]],"date-time":"2024-11-07T00:00:00Z","timestamp":1730937600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction\/Aims<\/jats:title>\n                    <jats:p>Prospective, randomized, controlled trials of intravenous immunoglobulin (IVIG) maintenance therapy in myasthenia gravis (MG) are lacking. In this trial, we evaluated the safety and efficacy of caprylate\/chromatography\u2010purified IVIG; (IGIV\u2010C) in patients with generalized MG undergoing standard care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Sixty\u2010two patients enrolled in this phase 2, multicenter, international, randomized trial (1:1 IGIV\u2010C [2\u2009g\/kg loading dose; 1\u2009g\/kg every 3\u2009weeks through week 21] or placebo). Efficacy was assessed by changes in Quantitative MG (QMG) score at week 24 versus baseline (primary endpoint) and percentage of patients with clinical improvement in QMG, MG Composite (MGC), and MG\u2010Activities of Daily Living (MG\u2010ADL) scores (secondary endpoints). Safety assessments reported all adverse events (AEs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The change in QMG at 24\u2009weeks was \u22125.1 for IGIV\u2010C and \u22123.1 for placebo (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.187). Seventy percent of patients in the IGIV\u2010C group had improvement in MG\u2010ADL (\u22652\u2010point decrease) versus 40.6% in the placebo group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.025). Patients showing clinical improvement in QMG and MGC (\u22653\u2010point decrease) were 70.0% for IGIV\u2010C versus 59.4% for placebo (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.442) and 60.0% for IGIV\u2010C versus 53.1% for placebo (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.610). IGIV\u2010C was well tolerated; serious AEs were similar between arms. Three of four MG exacerbations requiring hospitalizations occurred in the IGIV\u2010C arm with one death.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Several efficacy parameters showed numerical results greater than those seen in the placebo group. This was a small study and may have been underpowered to see significant differences. Additional studies may be warranted to fully determine the efficacy of IVIG maintenance therapy in MG.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mus.28289","type":"journal-article","created":{"date-parts":[[2024,11,7]],"date-time":"2024-11-07T04:08:58Z","timestamp":1730952538000},"page":"43-54","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Efficacy and safety of maintenance intravenous immunoglobulin in generalized myasthenia gravis patients with acetylcholine receptor antibodies: A multicenter, double\u2010blind, placebo\u2010controlled trial"],"prefix":"10.1002","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5805-4883","authenticated-orcid":false,"given":"Vera","family":"Bril","sequence":"first","affiliation":[{"name":"Toronto General Hospital  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomasz","family":"Berkowicz","sequence":"additional","affiliation":[{"name":"III Miejskie Centrum Medyczne im, Dr Karola Jonschera w \u0141odzi  Lodz Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrzej","family":"Szczudlik","sequence":"additional","affiliation":[{"name":"Centrum Neurologii Klinicznej  Krakow Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael W.","family":"Nicolle","sequence":"additional","affiliation":[{"name":"London Health Sciences Centre and Western University  London Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josef","family":"Bednarik","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Hospital Brno and Faculty of Medicine Masaryk University  Brno Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petr","family":"Hon","sequence":"additional","affiliation":[{"name":"Fakultni Nemocnice Ostrava, Neurologicka Klinika  Ostrava\u2010Poruba Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antanas","family":"Vaitkus","sequence":"additional","affiliation":[{"name":"Department of Neurology Hospital of Lithuanian University of Health Sciences, Kaunas Clinics  Kaunas Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0724-0210","authenticated-orcid":false,"given":"Tuan","family":"Vu","sequence":"additional","affiliation":[{"name":"Department of Neurology University of South Florida Morsani College of Medicine  Tampa Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Csilla","family":"Rozsa","sequence":"additional","affiliation":[{"name":"Jahn Ferenc Del\u2010pesti Korhaz es Rendelointezet Neurologiai Osztaly  Budapest Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Magnus","sequence":"additional","affiliation":[{"name":"Universitaetsklinikum Hamburg Eppendorf, Klinik und Poliklinik fuer Neurologie, Neurologische Studienzentrale  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gyula","family":"Panczel","sequence":"additional","affiliation":[{"name":"Department of Neurology Fl\u00f3r Ferenc County Hospital  Kistarcsa Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toomas","family":"Toomsoo","sequence":"additional","affiliation":[{"name":"East Tallinn Central Hospital  Tallinn Estonia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mamatha","family":"Pasnoor","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Kansas Medical Center  Kansas City Kansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1230-0188","authenticated-orcid":false,"given":"Tahseen","family":"Mozaffar","sequence":"additional","affiliation":[{"name":"University of California, Irvine  Orange California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Freimer","sequence":"additional","affiliation":[{"name":"Department of Neurology The Ohio State University  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrike","family":"Reuner","sequence":"additional","affiliation":[{"name":"Department of Neurology University Clinic Dresden, Technische Universit\u00e4t Dresden  Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L\u00e1szl\u00f3","family":"V\u00e9csei","sequence":"additional","affiliation":[{"name":"Department of Neurology, Albert Szent\u2010Gy\u00f6rgyi Clinical Center University of Szeged  Szeged Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nizar","family":"Souayah","sequence":"additional","affiliation":[{"name":"Department of Neurology Rutgers\u2010New Jersey Medical School  Newark New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd","family":"Levine","sequence":"additional","affiliation":[{"name":"Honor Health Neurology  Scottsdale Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert M.","family":"Pascuzzi","sequence":"additional","affiliation":[{"name":"Indiana School of Medicine  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marinos C.","family":"Dalakas","sequence":"additional","affiliation":[{"name":"Department of Neurology Thomas Jefferson University  Philadelphia Pennsylvania USA"},{"name":"National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Rivner","sequence":"additional","affiliation":[{"name":"Neurology\/EMG Laboratory Augusta University  Augusta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rhonda","family":"Griffin","sequence":"additional","affiliation":[{"name":"Grifols Bioscience Research Group  Research Triangle Park North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Montse Querolt","family":"Coll","sequence":"additional","affiliation":[{"name":"Grifols Bioscience Research Group  Sant Cugat Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elsa","family":"Mondou","sequence":"additional","affiliation":[{"name":"Grifols Bioscience Research Group  Research Triangle Park North Carolina 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