{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T08:26:17Z","timestamp":1781166377516,"version":"3.54.1"},"reference-count":15,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T00:00:00Z","timestamp":1771977600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T00:00:00Z","timestamp":1771977600000},"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":["82071434"],"award-info":[{"award-number":["82071434"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004608","name":"Natural Science Foundation of Jiangsu Province","doi-asserted-by":"publisher","award":["BK20201490"],"award-info":[{"award-number":["BK20201490"]}],"id":[{"id":"10.13039\/501100004608","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":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction\/Aims<\/jats:title>\n                    <jats:p>Despite conventional immunosuppressive therapy, approximately 5% of generalized myasthenia gravis (MG) patients experience residual ocular symptoms. We investigated the therapeutic effect of eculizumab, a C5 complement inhibitor, in five patients with refractory ocular myasthenia gravis (OMG) or ocular\u2010predominant MG.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Five patients with acetylcholine receptor antibody\u2010positive (AChR\u2010Ab) refractory ocular or ocular\u2010predominant MG received eculizumab therapy (induction: 900\u2009mg weekly \u00d74\u2009weeks; maintenance: 1200\u2009mg biweekly) with baseline immunosuppression. Each patient was followed up for 12\u2009weeks. Clinical assessments included ocular Quantitative Myasthenia Gravis (ocular\u2010QMG), Myasthenia Gravis Composite (MGC), and MG activities of daily living (MG\u2010ADL). Serum AChR\u2010Ab titers were measured before and after treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All patients experienced rapid symptom improvement within 1\u2009week. After 4\u2009weeks, ocular function normalized in three patients, with four patients achieving MGC \u2264\u20092 and MG\u2010ADL \u2264\u20092. The ocular\u2010QMG scores for individual items showed that both ptosis and diplopia improved in most patients. At 12\u2009weeks, four patients maintained stable symptom control. No treatment\u2010related adverse events or significant AChR\u2010Ab+ titer changes were observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>In patients with refractory ocular or ocular\u2010predominant MG, eculizumab had a rapid onset of therapeutic effect that was sustained after 12\u2009weeks, regardless of the antibody titer. The favorable safety profile supports its use in treatment\u2010resistant cases of refractory OMG or ocular\u2010predominant MG. Larger randomized controlled trials are needed to establish the long\u2010term effectiveness and optimize treatment protocols.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mus.70183","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T19:28:14Z","timestamp":1772998094000},"page":"887-891","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Safety and Effectiveness of Eculizumab in Patients With Refractory Ocular or Ocular\u2010Predominant Myasthenia Gravis: A Case Series"],"prefix":"10.1002","volume":"73","author":[{"given":"Shiyu","family":"Shi","sequence":"first","affiliation":[{"name":"Department of Geriatric Neurology The First Affiliated Hospital of Nanjing Medical University  Nanjing China"},{"name":"Jiangsu Provincial Key Laboratory of Biological Therapy for Organ Failure Nanjing Medical University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8813-3314","authenticated-orcid":false,"given":"Yu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Geriatric Neurology The First Affiliated Hospital of Nanjing Medical University  Nanjing China"},{"name":"Jiangsu Provincial Key Laboratory of Biological Therapy for Organ Failure Nanjing Medical University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenping","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Geriatric Neurology The First Affiliated Hospital of Nanjing Medical University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pan","family":"You","sequence":"additional","affiliation":[{"name":"Department of Geriatric Neurology The First Affiliated Hospital of Nanjing Medical University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Geriatric Neurology The First Affiliated Hospital of Nanjing Medical University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Niu","sequence":"additional","affiliation":[{"name":"Jiangsu Provincial Key Laboratory of Biological Therapy for Organ Failure Nanjing Medical University  Nanjing China"},{"name":"Department of Rare Diseases The First Affiliated Hospital of Nanjing Medical University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,25]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000010209"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cellimm.2025.104956"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drudis.2024.104134"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(17)30369-1"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-024-12569-w"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-024-12588-7"},{"issue":"1","key":"e_1_2_12_8_1","first-page":"1","article-title":"Chinese Guidelines for the Diagnosis and Treatment of Myasthenia Gravis (2020)","volume":"28","author":"Neuroimmunology Branch of the Chinese Society of Immunology","year":"2021","journal-title":"Chinese Journal of Neuroimmunology and Neurology"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000327669.75695.38"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000312374.95186.cc"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.52.7.1487"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-020-09770-y"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/WCO.0000000000001196"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2019.04.017"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.expneurol.2004.06.005"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-024-07368-0"}],"container-title":["Muscle &amp; 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