{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:27:37Z","timestamp":1790814457083,"version":"4.1.0"},"reference-count":51,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,10,28]],"date-time":"2024-10-28T00:00:00Z","timestamp":1730073600000},"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":"<jats:sec><jats:title>Background<\/jats:title><jats:p>As targeted drug development in myasthenia gravis (MG) continues to advance, it is important to compare the efficacy of these drugs for better clinical decision-making. However, due to the varied regimens and dosages used in clinical trials for different drugs, a standardized comparison between them is necessary.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study enrolled participants in phase II and III trials of innovative targeted drugs for MG. The primary outcome was the change in Quantitative Myasthenia Gravis score (MG-QMG) from baseline. The efficacy of all drugs at four time points was separately analyzed at four time points: initiation 1\u2009week, initiation 4\u2009weeks, maximized response, and post last dose 4\u2009weeks. A network meta-analysis was conducted to compare the results of the different drugs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 9 drugs, including Efgartigimod, Rozanolixizumab, Batoclimab, Eculizumab, Belimumab, Zilucoplan, Ravulizumab, Nipocalimab, Rituximab, derived from 12 studies were analyzed. At the initiation 1-week time point, three drugs exhibited significant improvement compared to the placebo effect: Efgartigimod, Zilucoplan, Rozanolixizumab. At the initiation 4-week time point, four drugs showed significant improvement compared to the placebo effect: Efgartigimod, Rozanolixizumab, Batoclimab, Zilucoplan. At the maximized response time point, six drugs achieved significant improvement compared to the placebo effect: Efgartigimod, Rozanolixizumab, Batoclimab, Eculizumab, Zilucoplan, Ravulizumab. At the post last dose 4-week point, all drugs statistically showed no significant difference from the placebo.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Although the MG subtypes were not consistent across trials, within the regimen design of each trial, neonatal Fc receptor inhibitors\u2014represented by Efgartigimod, Rozanolixizumab, and Batoclimab\u2014exhibited the most effective response rates when compared to complement and B-cell inhibitor drugs.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2024.1479685","type":"journal-article","created":{"date-parts":[[2024,10,28]],"date-time":"2024-10-28T05:10:29Z","timestamp":1730092229000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":13,"title":["Initiation response, maximized therapeutic efficacy, and post-treatment effects of biological targeted therapies in myasthenia gravis: a systematic review and network meta-analysis"],"prefix":"10.3389","volume":"15","author":[{"given":"Huahua","family":"Zhong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhijun","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xicheng","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zongtai","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chong","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sushan","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chongbo","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,10,28]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1038\/s41572-019-0079-y","article-title":"Myasthenia gravis","volume":"5","author":"Gilhus","year":"2019","journal-title":"Nat Rev Dis Prim"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1002\/acn3.51492","article-title":"Drug-refractory myasthenia gravis: clinical characteristics, treatments, and outcome","volume":"9","author":"Cort\u00e9s-Vicente","year":"2022","journal-title":"Ann Clin Transl Neurol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1186\/s12883-019-1573-2","article-title":"Understanding side effects of therapy for myasthenia gravis and their impact on daily life","volume":"19","author":"Bacci","year":"2019","journal-title":"BMC Neurol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"816243","DOI":"10.3389\/fneur.2022.816243","article-title":"Clinical predictors of relapse in a cohort of steroid-treated patients with well-controlled myasthenia gravis","volume":"13","author":"Su","year":"2022","journal-title":"Front Neurol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"822909","DOI":"10.3389\/fpubh.2022.822909","article-title":"Socio-economic burden of myasthenia gravis: a cost-of-illness study in Bulgaria","volume":"10","author":"Ignatova","year":"2022","journal-title":"Front Public Health"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"212","DOI":"10.3389\/fimmu.2020.00212","article-title":"Autoantibody specificities in myasthenia gravis; 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