{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T03:34:44Z","timestamp":1792812884748,"version":"4.5.0"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,7,29]],"date-time":"2024-07-29T00:00:00Z","timestamp":1722211200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2022YFC3501305, 2022YFC3501303"],"award-info":[{"award-number":["2022YFC3501305, 2022YFC3501303"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82071410, 82001335"],"award-info":[{"award-number":["82071410, 82001335"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Efgartigimod is effective and well-tolerated in patients with anti-acetylcholine receptor (AChR) antibody-positive generalized myasthenia gravis (MG). However, the therapeutic potential and the safety profile of efgartigimod in myasthenic crisis (MC) remained largely unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This is an observational, prospective, multicenter, real-world study to follow 2 MC patients who initiated efgartigimod as a first-line rescue therapy and 8 cases who used it as an add-on therapy. Baseline demographic features and immunotherapies were collected, and the MG-activities of daily living (MG-ADL) scale was evaluated every week since efgartigimod treatment for 8 weeks. Additionally, serum IgG and anti-AChR antibody levels and the peripheral CD4\n                      <jats:sup>+<\/jats:sup>\n                      T lymphocytes were measured before and after one cycle of treatment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Ten patients with MC were enrolled in the study, including 9 anti-AChR antibody positive and 1 anti-muscle-specific kinase (MuSK) positive. All patients were successfully weaned from the ventilation after receiving efgartigimod treatment, with a length of 10.44 \u00b1 4.30 days. After one cycle of infusions, the MG-ADL score reduced from 15.6 \u00b1 4.4 at the baseline to 3.4 \u00b1 2.2, while the corticosteroid dose was tapered from 55.0 \u00b1 20.7 mg to 26.0 \u00b1 14.1 mg. The proportions of regulatory T cells and na\u00efve T cells (% in CD4\n                      <jats:sup>+<\/jats:sup>\n                      T) significantly decreased post-efgartigimod treatment (5.48 \u00b1 1.23 vs. 6.90 \u00b1 1.80,\n                      <jats:italic>P<\/jats:italic>\n                      =0.0313, and 34.98 \u00b1 6.47 vs. 43.68 \u00b1 6.54,\n                      <jats:italic>P<\/jats:italic>\n                      =0.0313, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These findings validated the rapid action of efgartigimod in facilitating the weaning process with a good safety profile in patients with MC.<\/jats:p>\n                  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