{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T14:10:24Z","timestamp":1793974224307,"version":"4.8.0"},"reference-count":45,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Alexion Pharma Germany GmbH"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ther Adv Neurol Disord"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:p>Inhibition of terminal complement activation is an effective therapeutic strategy for acetylcholine receptor antibody\u2013positive generalized myasthenia gravis (gMG) and aquaporin-4 antibody\u2013positive neuromyelitis optica spectrum disorder (NMOSD), but it increases the risk of invasive meningococcal infections. Consequently, vaccination against meningococcal serogroups A, C, W, Y, and B is mandatory for all patients receiving complement inhibitors. This article provides expert consensus recommendations for managing meningococcal vaccination in patients with NMOSD and gMG receiving complement-inhibiting therapies in Germany, Austria, and Switzerland. The timing and procedures of vaccination should be adapted to the underlying diagnosis and the individual risk of disease exacerbation in this population. In NMOSD, treatment often must begin promptly, particularly after an acute attack; in such cases, vaccination should be administered at treatment initiation together with antibiotic prophylaxis. By contrast, treatment urgency in gMG is typically lower, allowing vaccination to be completed in advance and thereby avoiding antibiotic exposure, which may worsen gMG symptoms. For both diseases, ceftriaxone is recommended as first-line therapy for suspected infection, rifampicin for prophylaxis, and either rifampicin or intramuscular ceftriaxone for post-exposure chemoprophylaxis. Patients should also carry a standby dose of ciprofloxacin for emergency self-administration at the first signs of meningitis, followed by immediate clinical evaluation. These recommendations should be reviewed regularly and updated as necessary to reflect emerging evidence and new vaccine options.<\/jats:p>","DOI":"10.1177\/17562864261442558","type":"journal-article","created":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T11:42:57Z","timestamp":1778240577000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Meningococcal prophylaxis in neurological diseases treated with complement inhibitors: an expert consensus for Germany, Austria, and Switzerland"],"prefix":"10.1177","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9650-6222","authenticated-orcid":false,"given":"Achim","family":"Berthele","sequence":"first","affiliation":[{"name":"Department of Neurology, School of Medicine and Health, Technical University Munich, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orhan","family":"Aktas","sequence":"additional","affiliation":[{"name":"Heinrich Heine University, D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilya","family":"Ayzenberg","sequence":"additional","affiliation":[{"name":"Department of Neurology, Ruhr University Bochum, St. Josef Hospital, Bochum, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heike","family":"Claus","sequence":"additional","affiliation":[{"name":"National Reference Center for Meningococci and Haemophilus influenzae, Institute for Hygiene and Microbiology, University of W\u00fcrzburg, W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thi\u00ean-Tr\u00ed","family":"L\u00e2m","sequence":"additional","affiliation":[{"name":"National Reference Center for Meningococci and Haemophilus influenzae, Institute for Hygiene and Microbiology, University of 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Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harald","family":"Pr\u00fcss","sequence":"additional","affiliation":[{"name":"Department of Neurology with Experimental Neurology, Neuroscience Clinical Research Center, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Berlin, Germany"},{"name":"German Center for Neurodegenerative Diseases (DZNE) Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"Rademacher","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marius","family":"Ringelstein","sequence":"additional","affiliation":[{"name":"Heinrich Heine University, D\u00fcsseldorf, Germany"},{"name":"Department of Neurology, Center for Neurology and Neuropsychiatry, LVR Klinikum, Heinrich Heine Universit\u00e4t, D\u00fcsseldorf, 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