{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T17:14:23Z","timestamp":1793812463216,"version":"4.6.1"},"reference-count":12,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,6,11]],"date-time":"2024-06-11T00:00:00Z","timestamp":1718064000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"Purpose<\/jats:title>To describe the early experience of ravulizumab use in acetylcholine receptor antibody-positive generalized myasthenia gravis (AChR+ve gMG).<\/jats:p><\/jats:sec>Methods<\/jats:title>This multicenter retrospective study included AChR+ve gMG patients who were treated with ravulizumab and had both pre- and post-ravulizumab myasthenia gravis activities of daily living (MG-ADL) scores. Clinical information regarding MG history, concomitant treatment(s), MG-ADL, other MG-specific measures, and adverse events were recorded.<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 18 patients with mean age of 61.83 (\u00b116.08, n<\/jats:italic>\u2009=\u200918) years were included in this cohort. In 10 complement inhibitor naive patients, a clinically meaningful reduction in mean Mg-ADL (baseline: 6.6 (\u00b13.58) vs. 4.4 (\u00b12.28), post ravulizumab) was seen. 6 out of 10 patients (60%) had clinically meaningful reduction post ravulizumab and two achieved minimum symptom expression (MSE). In 8 patients switched from eculizumab to ravulizumab, further reduction was noted in post ravulizumab mean MG-ADL (Baseline: 3.25 (\u00b13.34) vs. 1.5 (\u00b12.34) post ravulizumab). None of the patients who switched from eculizumab to ravulizumab experienced worsening symptoms. Eleven out of 14 (78.5%) patients on prednisone therapy were able to reduce their prednisone dose post-ravulizumab. None of the patients experienced any major side effects.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>In our clinical practice, 60% of AChR+ve gMG complement inhibitor naive patients experienced a clinically meaningful improvement in MG-ADL scores with ravulizumab. Patients were safely switched from eculizumab to ravulizumab and had further improvement in their mean MG-ADL scores. Of those on prednisone therapy, the majority were able to reduce their prednisone dosage.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2024.1378080","type":"journal-article","created":{"date-parts":[[2024,6,11]],"date-time":"2024-06-11T16:21:38Z","timestamp":1718122898000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["Ravulizumab use for acetylcholine receptor-positive generalized myasthenia gravis in clinical practice"],"prefix":"10.3389","volume":"15","author":[{"given":"Nakul","family":"Katyal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raghav","family":"Govindarajan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neelam","family":"Goyal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suraj","family":"Muley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srikanth","family":"Muppidi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,6,11]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1016\/S1474-4422(23)00080-7","article-title":"Safety and efficacy of zilucoplan in patients with generalised myasthenia gravis (RAISE): a randomised, double-blind, placebo-controlled, phase 3 study","volume":"22","author":"Howard","year":"2023","journal-title":"Lancet Neurol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1016\/S1474-4422(23)00077-7","article-title":"Safety and efficacy of rozanolixizumab in patients with generalised myasthenia gravis (MycarinG): a randomised, double-blind, placebo-controlled, adaptive phase 3 study","volume":"22","author":"Bril","year":"2023","journal-title":"Lancet Neurol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"976","DOI":"10.1016\/S1474-4422(17)30369-1","article-title":"Safety and efficacy of eculizumab in anti-acetylcholine receptor antibody-positive refractory generalised myasthenia gravis (REGAIN): a phase 3, randomised, double-blind, placebo-controlled, multicentre study","volume":"16","author":"Howard","year":"2017","journal-title":"Lancet Neurol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"EVIDoa2100066","DOI":"10.1056\/EVIDoa2100066","article-title":"Terminal complement inhibitor Ravulizumab in generalized myasthenia gravis","volume":"1","author":"Vu","year":"2022","journal-title":"NEJM Evid"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"3129","DOI":"10.1007\/s00415-023-11617-1","article-title":"Ravulizumab pharmacokinetics and pharmacodynamics in patients with generalized myasthenia gravis","volume":"270","author":"Vu","year":"2023","journal-title":"J Neurol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"540","DOI":"10.1182\/blood-2018-09-876805","article-title":"Ravulizumab (ALXN1210) vs eculizumab in C5-inhibitor-experienced adult patients with PNH: the 302 study","volume":"133","author":"Kulasekararaj","year":"2019","journal-title":"Blood"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"3862","DOI":"10.1007\/s00415-023-11699-x","article-title":"Long-term efficacy and safety of ravulizumab in adults with anti-acetylcholine receptor antibody-positive generalized myasthenia gravis: results from the phase 3 CHAMPION MG open-label extension","volume":"270","author":"Meisel","year":"2023","journal-title":"J Neurol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1487","DOI":"10.1212\/wnl.52.7.1487","article-title":"Barohn RJ myasthenia gravis activities of daily living profile","volume":"52","year":"1999","journal-title":"Neurology"},{"key":"ref9","year":"2023"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"e1169","DOI":"10.1212\/NXI.0000000000001169","article-title":"Heterogeneity of acetylcholine receptor autoantibody-mediated complement activity in patients with myasthenia gravis","volume":"9","author":"Obaid","year":"2022","journal-title":"Neurol Neuroimmunol Neuroinflamm"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1005","DOI":"10.1007\/s00401-022-02493-6","article-title":"Receptor clustering and pathogenic complement activation in myasthenia gravis depend on synergy between antibodies with multiple subunit specificities","volume":"144","author":"Rose","year":"2022","journal-title":"Acta Neuropathol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1756286420932035","DOI":"10.1177\/1756286420932035","article-title":"Eculizumab as a promising treatment in thymoma-associated myasthenia gravis","volume":"13","author":"V\u00e9lez-Santamar\u00eda","year":"2020","journal-title":"Ther Adv Neurol Disord"}],"container-title":["Frontiers in 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