{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T07:23:09Z","timestamp":1787728989687,"version":"build-2784847793"},"reference-count":29,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Myasthenia gravis (MG) is increasingly concentrated in older adults, and age may shift the balance of benefit and risk for MG therapies. This study seeks to evaluate the effect of age on treatment efficacy in clinical trials of MG.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed and Cochrane Library were searched and clinical trials enrolling adults with MG that reported the quantitative myasthenia gravis (QMG) score and the myasthenia gravis activities of daily living (MG\u2010ADL) scale were included. Of 2214 records identified, 18 trials met inclusion criteria. Random\u2010effects meta\u2010analysis was used to pool treatment effects, and random\u2010effects meta\u2010regression evaluated trial\u2010level mean baseline age as a modifier of treatment efficacy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eighteen trials published from 2017 to 2025 included 1823 participants (982 assigned to treatment and 841 to control). Pooled effects favored treatment over control for the QMG (MD \u22122.402; 95% CI, \u22123.099 to \u22121.706; \u2009=\u200960.7%) and MG\u2010ADL scores (MD, \u22121.591; 95% CI, \u22121.874 to \u22121.309; \u2009=\u20090.0%). In meta\u2010regression, higher mean trial age was associated with attenuation of treatment benefit on the QMG scale (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      per 10\u2009years, 1.21; 95% CI, 0.02 to 2.42;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.047). This effect was most pronounced for FcRn inhibitors. No association was observed for the MG\u2010ADL score (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      per 10\u2009years, 0.08; 95% CI, \u22120.50 to 0.66;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.779).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this meta\u2010analysis, older trial populations showed smaller treatment\u2010related improvements in the QMG but not in the MG\u2010ADL score. These findings suggest that age may contribute to differences in treatment effects across MG trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ene.70737","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T06:42:03Z","timestamp":1786603323000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Age and Treatment Efficacy in Myasthenia Gravis: A Systematic Review, Meta\u2010Analysis, and Meta\u2010Regression"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6633-982X","authenticated-orcid":false,"given":"Christopher","family":"Nelke","sequence":"first","affiliation":[{"name":"Department of Neurology, BG University Hospital Bergmannsheil Ruhr University Bochum  Bochum Germany"},{"name":"BG University Hospital Bergmannsheil Heimer Institute for Muscle Research  Bochum Germany"},{"name":"Department of Neurology, Medical Faculty Heinrich Heine University Duesseldorf  Duesseldorf Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marion","family":"Skrobol","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical Faculty Heinrich Heine University Duesseldorf  Duesseldorf Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"Theissen","sequence":"additional","affiliation":[{"name":"Department of Neurology, BG University Hospital Bergmannsheil Ruhr University Bochum  Bochum Germany"},{"name":"BG University Hospital Bergmannsheil Heimer Institute for Muscle Research  Bochum Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1323-6317","authenticated-orcid":false,"given":"Francesco","family":"Sacca","sequence":"additional","affiliation":[{"name":"GENESIS Department Federico II University of Naples  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6332-8650","authenticated-orcid":false,"given":"Tobias","family":"Ruck","sequence":"additional","affiliation":[{"name":"Department of Neurology, BG University Hospital Bergmannsheil Ruhr University Bochum  Bochum Germany"},{"name":"BG University Hospital Bergmannsheil Heimer Institute for Muscle Research  Bochum Germany"},{"name":"Department of Neurology, Medical Faculty Heinrich Heine University Duesseldorf  Duesseldorf Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1602678"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI179742"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41582-023-00916-w"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000007600"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000011108"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2024.0044"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(23)00077-7"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(24)00498-8"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(17)30369-1"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2019.5125"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.70158"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(23)00080-7"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000210005"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmd.2023.02.002"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1172\/jci.insight.199679"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000214428"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-14-25"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-021-03547-7"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.78017"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmet.2024.01.015"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cellimm.2018.07.009"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-024-53595-6"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.13867"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.52.7.1487"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.70262"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.16280"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/ane.13549"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1056\/EVIDoa2100066"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-021-01310-0"}],"container-title":["European Journal of Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ene.70737","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ene.70737","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ene.70737","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T06:31:06Z","timestamp":1787725866000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ene.70737"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":29,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1111\/ene.70737"],"URL":"https:\/\/doi.org\/10.1111\/ene.70737","archive":["Portico"],"relation":{},"ISSN":["1351-5101","1468-1331"],"issn-type":[{"value":"1351-5101","type":"print"},{"value":"1468-1331","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8]]},"assertion":[{"value":"2026-05-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70737"}}