{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T18:02:00Z","timestamp":1771351320634,"version":"3.50.1"},"reference-count":9,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T00:00:00Z","timestamp":1770163200000},"content-version":"vor","delay-in-days":3,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Justus-Liebig-Universit\u00e4t Gie\u00dfen"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Neurol Sci"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Endplate-protecting therapies have improved treatment of myasthenia gravis and indicate a rapid onset of their treatment effect. Currently, these substances can be used following myasthenic exacerbation (ME). Clinical worsening due to ME however often results in prolonged recovery. We here evaluated the treatment courses of patients having received endplate-protecting treatment following ME. Among 12 patients with ME described here, seven received endplate-protecting therapies. Our findings indicate that acceptable recovery usually takes nine months. In the lights of recent trials for treatment of myasthenia, our findings implicate that the effectiveness of novel substances should be judged only after sufficient observation periods.<\/jats:p>","DOI":"10.1007\/s10072-025-08617-6","type":"journal-article","created":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T02:51:52Z","timestamp":1770173512000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Delayed recovery following myasthenic exacerbation and subsequent endplate-protecting treatment"],"prefix":"10.1007","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-6943-5867","authenticated-orcid":false,"given":"Anna","family":"M\u00fcck","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonja","family":"Genau","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"Emde","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"Best","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steffen","family":"Pfeuffer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heidrun H.","family":"Kr\u00e4mer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,2,4]]},"reference":[{"key":"8617_CR1","doi-asserted-by":"publisher","first-page":"538","DOI":"10.3389\/fneur.2020.00538","volume":"11","author":"D Menon","year":"2020","unstructured":"Menon D, Barnett C, Bril V (2020) Novel treatments in myasthenia gravis. Front Neurol 11:538","journal-title":"Front Neurol"},{"issue":"8","key":"8617_CR2","doi-asserted-by":"publisher","first-page":"5650","DOI":"10.1007\/s00415-024-12478-y","volume":"271","author":"A Muck","year":"2024","unstructured":"Muck A et al (2024) Myasthenic crises are associated with negative long-term outcomes in myasthenia Gravis. J Neurol 271(8):5650\u20135655","journal-title":"J Neurol"},{"issue":"12","key":"8617_CR3","doi-asserted-by":"publisher","first-page":"e1617","DOI":"10.1212\/WNL.0000000000010574","volume":"95","author":"M Mendoza","year":"2020","unstructured":"Mendoza M et al (2020) Patient-acceptable symptom states in myasthenia gravis. Neurology 95(12):e1617\u2013e1628","journal-title":"Neurology"},{"issue":"7","key":"8617_CR4","doi-asserted-by":"publisher","first-page":"526","DOI":"10.1016\/S1474-4422(21)00159-9","volume":"20","author":"JF Howard Jr","year":"2021","unstructured":"Howard JF Jr. et al (2021) Safety, efficacy, and tolerability of Efgartigimod in patients with generalised myasthenia Gravis (ADAPT): a multicentre, randomised, placebo-controlled, phase 3 trial. Lancet Neurol 20(7):526\u2013536","journal-title":"Lancet Neurol"},{"issue":"5","key":"8617_CR5","doi-asserted-by":"publisher","first-page":"EVIDoa2100066","DOI":"10.1056\/EVIDoa2100066","volume":"1","author":"T Vu","year":"2022","unstructured":"Vu T et al (2022) Terminal complement inhibitor ravulizumab in generalized myasthenia Gravis. NEJM Evid 1(5):EVIDoa2100066","journal-title":"NEJM Evid"},{"issue":"5","key":"8617_CR6","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1016\/S1474-4422(23)00077-7","volume":"22","author":"V Bril","year":"2023","unstructured":"Bril V et al (2023) Safety and efficacy of Rozanolixizumab in patients with generalised myasthenia Gravis (MycarinG): a randomised, double-blind, placebo-controlled, adaptive phase 3 study. Lancet Neurol 22(5):383\u2013394","journal-title":"Lancet Neurol"},{"issue":"5","key":"8617_CR7","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1016\/S1474-4422(23)00080-7","volume":"22","author":"JF Howard Jr","year":"2023","unstructured":"Howard JF Jr. et al (2023) Safety and efficacy of Zilucoplan in patients with generalised myasthenia Gravis (RAISE): a randomised, double-blind, placebo-controlled, phase 3 study. Lancet Neurol 22(5):395\u2013406","journal-title":"Lancet Neurol"},{"issue":"4","key":"8617_CR8","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1136\/jnnp-2024-334404","volume":"96","author":"N Huntemann","year":"2025","unstructured":"Huntemann N et al (2025) C5 complement inhibition versus FcRn modulation in generalised myasthenia gravis. J Neurol Neurosurg Psychiatry 96(4):310\u2013321","journal-title":"J Neurol Neurosurg Psychiatry"},{"issue":"1","key":"8617_CR9","doi-asserted-by":"publisher","first-page":"e200331","DOI":"10.1212\/NXI.0000000000200331","volume":"12","author":"F Stascheit","year":"2025","unstructured":"Stascheit F et al (2025) Ravulizumab and efgartigimod in myasthenia gravis: a real-world study. Neurol Neuroimmunol Neuroinflamm 12(1):e200331","journal-title":"Neurol Neuroimmunol Neuroinflamm"}],"container-title":["Neurological Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10072-025-08617-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10072-025-08617-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10072-025-08617-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T17:03:17Z","timestamp":1771347797000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10072-025-08617-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":9,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["8617"],"URL":"https:\/\/doi.org\/10.1007\/s10072-025-08617-6","relation":{},"ISSN":["1590-1874","1590-3478"],"issn-type":[{"value":"1590-1874","type":"print"},{"value":"1590-3478","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2]]},"assertion":[{"value":"7 July 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 November 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 February 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was approved by the Justus-Liebig University ethics committee (189\/22 and 53\/23).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"All patients gave informed consent.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"Potential conflicts of interest are related to the manufacturers of the endplate-protecting treatments discussed here: UCB (zilocuplan), Argenx (efgartigimod alfa), Alexion (ravulizumab). SG declares travel reimbursements from Alexion. SP declares travel reimbursements and consulting fees from Alexion. HHK declares lecturing honoraria and consulting fees from Alexion, Argenx, and UCB, travel reimbursements of Alexion, and research support from Roche and Argenx. AM, JE and CB declare no conflicts of interest.AM: declares no conflicts of interestSG: declares no conflicts of interest.JE: declares no conflicts of interestCB: received honoraria for lecturing and for serving on advisory boards from Bayer, Novartis, and Portola.SP: received honoraria for lecturing and for serving on advisory boards from Argenx, Alexion, Biogen, Hexal, Merck Healthcare, Novartis, Roche, and Sanofi Aventis; travel reimbursements from Alexion, Biogen, Merck Healthcare, neuraxpharm, and Roche; research support from Biogen, Merck Healthcare, and Novartis.HHK: received honoraria for lecturing and for serving on advisory boards from Alexion, Alnylam, Amgen, Argenx, Roche, Sanofi Aventis, and UCB; travel reimbursements from Alexion, Alnylam, Griffols, and Sanofi Aventis; research support from Argenx and Roche.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}}],"article-number":"227"}}