{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T01:28:55Z","timestamp":1792114135653,"version":"4.4.0"},"reference-count":76,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T00:00:00Z","timestamp":1759881600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"JSPS KAKENHI","award":["JP 23K00487"],"award-info":[{"award-number":["JP 23K00487"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurology International"],"abstract":"<jats:p>Myasthenia gravis (MG) is a chronic autoimmune disorder characterized by fluctuating skeletal muscle weakness. Myasthenic crisis (MCr), a severe and potentially life-threatening complication, presents with respiratory failure and requires intensive care and rapid immunomodulatory intervention. Conventional MCr treatments\u2014such as plasma exchange (PLEX), intravenous immunoglobulin (IVIG), and intravenous methylprednisolone (IVMP)\u2014remain standard treatments; however, they present significant limitations, including delayed onset of action, adverse effects, and inconsistent efficacy. Recent therapeutic advances have led to the development of molecularly targeted therapies based on MG pathophysiology, particularly neonatal Fc receptor (FcRn) inhibitors and complement inhibitors, which have shown efficacy in refractory or maintenance settings. This review explores the potential application of these agents in MCr. We review published case reports involving FcRn inhibitors (efgartigimod, efgartigimod-SC, rozanolixizumab) and complement inhibitors (eculizumab, ravulizumab, zilucoplan), highlighting their rapid onset of action and safety profiles in MCr. While efgartigimod and eculizumab are the most commonly reported agents in MCr, data remain limited to small case series. Emerging evidence suggests these agents may offer effective alternatives to conventional therapies, with favorable safety and potential for rapid symptom resolution. We also discuss strategic considerations for therapy selection, including antibody subtype, coexisting autoimmune conditions, genetic factors, and transition to long-term maintenance. Though the current evidence is promising, large-scale randomized studies are needed to establish definitive roles for these therapies in MCr management.<\/jats:p>","DOI":"10.3390\/neurolint17100163","type":"journal-article","created":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T12:04:52Z","timestamp":1759925092000},"page":"163","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Management of Myasthenic Crisis and Emerging Roles of Molecularly Targeted Therapies: A Narrative Review"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-0396-1413","authenticated-orcid":false,"given":"Seiya","family":"Takahashi","sequence":"first","affiliation":[{"name":"Department of Neurology, Showa Medical University Fujigaoka Hospital, 1-30 Fujigaoka Aoba-Ku, Yokohama-Shi 227-8501, Kanagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1905-2869","authenticated-orcid":false,"given":"Ryuta","family":"Kinno","sequence":"additional","affiliation":[{"name":"Department of Neurology, Showa Medical University Fujigaoka Hospital, 1-30 Fujigaoka Aoba-Ku, Yokohama-Shi 227-8501, Kanagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Fichtner, M.L., Jiang, R., Bourke, A., Nowak, R.J., and O\u2019Connor, K.C. (2020). Autoimmune pathology in myasthenia gravis disease subtypes is governed by divergent mechanisms of immunopathology. Front. Immunol., 11.","DOI":"10.3389\/fimmu.2020.00776"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1177\/1941875210382918","article-title":"Myasthenic crisis","volume":"1","author":"Wendell","year":"2011","journal-title":"Neurohospitalist"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Yoshikawa, H., Adachi, Y., Nakamura, Y., Kuriyama, N., Murai, H., Nomura, Y., Sakai, Y., Iwasa, K., Furukawa, Y., and Kuwabara, S. (2022). Two-step nationwide epidemiological survey of myasthenia gravis in Japan 2018. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0274161"},{"key":"ref_4","doi-asserted-by":"crossref","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. Primers"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2304","DOI":"10.1093\/brain\/awg223","article-title":"Clinical correlates with anti-MuSK antibodies in generalized seronegative myasthenia gravis","volume":"126","author":"Evoli","year":"2003","journal-title":"Brain"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1111\/nyas.13573","article-title":"Agrin and LRP4 antibodies as new biomarkers of myasthenia gravis","volume":"1413","author":"Yan","year":"2018","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"S260","DOI":"10.1097\/JTO.0b013e3181f1f62d","article-title":"Epidemiology of thymoma and associated malignancies","volume":"5","author":"Engels","year":"2010","journal-title":"J. Thorac. Oncol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2017","DOI":"10.1212\/WNL.0b013e31821e5505","article-title":"Comparison of IVIg and PLEX in patients with myasthenia gravis","volume":"76","author":"Barth","year":"2011","journal-title":"Neurology"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1212\/01.wnl.0000256698.69121.45","article-title":"IV immunoglobulin in patients with myasthenia gravis: A randomized controlled trial","volume":"68","author":"Zinman","year":"2007","journal-title":"Neurology"},{"key":"ref_10","first-page":"CD002275","article-title":"Plasma exchange for myasthenia gravis","volume":"2002","author":"Gajdos","year":"2002","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1016\/S1474-4422(21)00159-9","article-title":"Safety, efficacy, and tolerability of efgartigimod in patients with generalised myasthenia gravis (ADAPT): A multicentre, randomised, placebo-controlled, phase 3 trial","volume":"20","author":"Howard","year":"2021","journal-title":"Lancet Neurol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"102337","DOI":"10.1016\/j.jaut.2019.102337","article-title":"Risk factors associated with myasthenia gravis in thymoma patients: The potential role of thymic germinal centers","volume":"106","author":"Lefeuvre","year":"2020","journal-title":"J. Autoimmun."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"314","DOI":"10.21037\/jtd.2016.03.03","article-title":"Increased frequency of thymic T follicular helper cells in myasthenia gravis patients with thymoma","volume":"8","author":"Song","year":"2016","journal-title":"J. Thorac. Dis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1093\/intimm\/dxg088","article-title":"Spontaneous production of anti-IFN-\u03b1 and anti-IL-12 autoantibodies by thymoma cells from myasthenia gravis patients suggests autoimmunization in the tumor","volume":"15","author":"Shiono","year":"2003","journal-title":"Int. Immunol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1038\/nrrheum.2011.1","article-title":"Long-lived autoreactive plasma cells drive persistent autoimmune inflammation","volume":"7","author":"Hiepe","year":"2011","journal-title":"Nat. Rev. Rheumatol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"689","DOI":"10.4161\/mabs.28254","article-title":"Quantitative cumulative biodistribution of antibodies in mice: Effect of modulating binding affinity to the neonatal Fc receptor","volume":"6","author":"Yip","year":"2014","journal-title":"MAbs"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Pyzik, M., Sand, K.M.K., Hubbard, J.J., Andersen, J.T., Sandlie, I., and Blumberg, R.S. (2019). The Neonatal Fc Receptor (FcRn): A Misnomer?. Front. Immunol., 10.","DOI":"10.3389\/fimmu.2019.01540"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2122","DOI":"10.1016\/S0140-6736(00)05186-2","article-title":"Myasthenia gravis","volume":"357","author":"Vincent","year":"2001","journal-title":"Lancet"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1111\/pai.13635","article-title":"Inherited defects in the complement system","volume":"33","author":"Leonardi","year":"2022","journal-title":"Pediatr. Allergy Immunol."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Bayly-Jones, C., Bubeck, D., and Dunstone, M.A. (2017). The mystery behind membrane insertion: A review of the complement membrane attack complex. Philos. Trans. R. Soc. Lond. B Biol. Sci., 372.","DOI":"10.1098\/rstb.2016.0221"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1515\/revneuro-2014-0021","article-title":"Targeting complement system to treat myasthenia gravis","volume":"25","author":"Huda","year":"2014","journal-title":"Rev. Neurosci."},{"key":"ref_22","first-page":"851","article-title":"Visualization and characterization of complement activation in acetylcholine receptor antibody seropositive myasthenia gravis","volume":"70","author":"Huang","year":"2024","journal-title":"Muscle Nerve"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1111\/cei.13302","article-title":"Relation of HLA-DRB1 to IgG4 autoantibody and cytokine production in muscle-specific tyrosine kinase myasthenia gravis (MuSK-MG)","volume":"197","author":"Aysal","year":"2019","journal-title":"Clin. Exp. Immunol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1586\/eci.12.34","article-title":"Muscle autoantibodies in myasthenia gravis: Beyond diagnosis?","volume":"8","author":"Meriggioli","year":"2012","journal-title":"Expert. Rev. Clin. Immunol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1002\/mus.27341","article-title":"Myasthenia gravis exacerbation in association with antibody overshoot following plasmapheresis","volume":"64","author":"Ching","year":"2021","journal-title":"Muscle Nerve"},{"key":"ref_26","first-page":"100","article-title":"Neuromusclar junction and myasthenic crisis","volume":"102","author":"Mayer","year":"1977","journal-title":"Trans. Am. Neurol. Assoc."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1002\/acn3.51312","article-title":"In-depth peripheral CD4+ T profile correlates with myasthenic crisis","volume":"8","author":"Huan","year":"2021","journal-title":"Ann. Clin. Transl. Neurol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.mce.2010.04.005","article-title":"The anti-inflammatory and immunosuppressive effects of glucocorticoids, recent developments and mechanistic insights","volume":"335","author":"Coutinho","year":"2011","journal-title":"Mol. Cell Endocrinol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1016\/0167-5699(92)90111-J","article-title":"The mechanism of action of cyclosporin A and FK506","volume":"13","author":"Schreiber","year":"1992","journal-title":"Immunol. Today"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1111\/voxs.12037","article-title":"The mechanisms of action of IVIG in autoimmune and inflammatory diseases","volume":"8","author":"Patil","year":"2013","journal-title":"ISBT Sci. Ser."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1136\/jnnp.68.2.214","article-title":"Extraocular muscle responses to high dose intravenous methylprednisolone in myasthenia gravis","volume":"68","author":"Komiyama","year":"2000","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1196\/annals.1405.037","article-title":"Extraocular muscle susceptibility to myasthenia gravis: Unique immunological environment?","volume":"1132","author":"Soltys","year":"2008","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1111\/j.1600-0404.1998.tb05968.x","article-title":"Treatment of myasthenia gravis with methylprednisolone pulse: A double blind study","volume":"97","author":"Lindberg","year":"1998","journal-title":"Acta Neurol. Scand."},{"key":"ref_34","doi-asserted-by":"crossref","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":"ref_35","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1038\/s41573-019-0031-6","article-title":"Clinical promise of next-generation complement therapeutics","volume":"18","author":"Mastellos","year":"2019","journal-title":"Nat. Rev. Drug Discov."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"4372","DOI":"10.1172\/JCI97911","article-title":"Neonatal Fc receptor antagonist efgartigimod safely and sustainably reduces IgGs in humans","volume":"128","author":"Ulrichts","year":"2018","journal-title":"J. Clin. Investig."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1007\/s00415-023-11970-1","article-title":"Efgartigimod beyond myasthenia gravis: The role of FcRn-targeting therapies in stiff-person syndrome","volume":"271","author":"Alonge","year":"2024","journal-title":"J. Neurol."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Watanabe, K., Takahashi, S., Kanda, A., Watanabe, T., Kakinuma, Y., Yano, S., and Kinno, R. (2025). Case Report: Therapeutic effect of efgartigimod in refractory anti-GQ1b antibody syndrome coexisting with myasthenia gravis. Front. Immunol., 16.","DOI":"10.3389\/fimmu.2025.1605985"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Takenobu, Y., Ikeda, K., Hasebe, S., Nomura, N., Tamaki, S., Yukawa, K., Miyahara, J., Yamakawa, K., and Inoue, M. (Immunol. Med., 2025). Rapid response of eculizumab: A rescue therapy for ventilator-dependent refractory myasthenic crisis, Immunol. Med., in press.","DOI":"10.1080\/25785826.2025.2500698"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"2898","DOI":"10.1007\/s00415-024-12234-2","article-title":"Ravulizumab in myasthenic crisis: The first case report","volume":"271","author":"Konen","year":"2024","journal-title":"J. Neurol."},{"key":"ref_41","first-page":"e80203","article-title":"Zilucoplan for Successful Early Weaning From Mechanical Ventilation and Avoiding Tracheostomy in an 85-Year-Old Woman Experiencing Myasthenic Crisis: A Case Report","volume":"17","author":"Ito","year":"2025","journal-title":"Cureus"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"2639","DOI":"10.2147\/NDT.S374694","article-title":"Ravulizumab in Myasthenia Gravis: A Review of the Current Evidence","volume":"19","author":"Vu","year":"2023","journal-title":"Neuropsychiatr. Dis. Treat."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"207","DOI":"10.2147\/DHPS.S257009","article-title":"Risk Analysis of Eculizumab-Related Meningococcal Disease in Japan Using the Japanese Adverse Drug Event Report Database","volume":"12","author":"Matsumura","year":"2020","journal-title":"Drug Healthc. Patient Saf."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1016\/j.jinf.2019.12.008","article-title":"Invasive meningococcal disease: Timing and cause of death in England, 2008-2015","volume":"80","author":"Beebeejaun","year":"2020","journal-title":"J Infect"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1212\/WNL.52.3.629","article-title":"Plasma exchange versus intravenous immunoglobulin treatment in myasthenic crisis","volume":"52","author":"Qureshi","year":"1999","journal-title":"Neurology"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1756286420986747","DOI":"10.1177\/1756286420986747","article-title":"VNTR2\/VNTR3 genotype in the FCGRT gene is associated with reduced effectiveness of intravenous immunoglobulin in patients with myasthenia gravis","volume":"14","author":"Su","year":"2021","journal-title":"Ther. Adv. Neurol. Disord."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1111\/cen3.12739","article-title":"The Japanese clinical guidelines 2022 for myasthenia gravis and Lambert\u2013Eaton myasthenic syndrome","volume":"14","author":"Murai","year":"2023","journal-title":"Clin. Exp. Neuroimmunol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"e00378","DOI":"10.1016\/j.neurot.2024.e00378","article-title":"Subcutaneous efgartigimod PH20 in generalized myasthenia gravis: A phase 3 randomized noninferiority study (ADAPT-SC) and interim analyses of a long-term open-label extension study (ADAPT-SC+)","volume":"21","author":"Howard","year":"2024","journal-title":"Neurotherapeutics"},{"key":"ref_49","doi-asserted-by":"crossref","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":"ref_50","doi-asserted-by":"crossref","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":"ref_51","doi-asserted-by":"crossref","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":"ref_52","doi-asserted-by":"crossref","unstructured":"Ma, J., Zhang, H., Zhao, J., Su, M., Feng, Y., Yuan, X., Liu, D., Pang, X., Zhao, R., and Wang, J. (2024). Efgartigimod versus intravenous immunoglobulin in the treatment of patients with impending myasthenic crisis. Sci. Rep., 14.","DOI":"10.1038\/s41598-024-79918-7"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1007\/s40267-024-01077-6","article-title":"Rozanolixizumab in generalized myasthenia gravis: A profile of its use","volume":"40","author":"Hoy","year":"2024","journal-title":"Drugs Ther. Perspect."},{"key":"ref_54","first-page":"e50692","article-title":"Exacerbation of Thymoma-Associated Myasthenia Gravis Following Efgartigimod Treatment Related to Anti-acetylcholine Receptor Antibody Overshoot: A Report of Two Cases","volume":"15","author":"Kawama","year":"2023","journal-title":"Cureus"},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Watanabe, K., Ohashi, S., Watanabe, T., Kakinuma, Y., and Kinno, R. (2024). Case report: Recovery from refractory myasthenic crisis to minimal symptom expression after add-on treatment with efgartigimod. Front. Neurol., 15.","DOI":"10.3389\/fneur.2024.1321058"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"17562864241254895","DOI":"10.1177\/17562864241254895","article-title":"Rescue treatment with add-on efgartigimod in a patient with impending myasthenic crisis: A case report","volume":"17","author":"Zhang","year":"2024","journal-title":"Ther. Adv. Neurol. Disord."},{"key":"ref_57","first-page":"9455237","article-title":"Efgartigimod as Rescue Medication in a Patient with Therapy-Refractory Myasthenic Crisis","volume":"2024","author":"Diel","year":"2024","journal-title":"Case Rep. Neurol. Med."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"578431","DOI":"10.1016\/j.jneuroim.2024.578431","article-title":"Efgartigimod as a fast-acting add-on therapy in manifest and impending myasthenic crisis: A single-center case series","volume":"395","author":"Hong","year":"2024","journal-title":"J. Neuroimmunol."},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Song, J., Wang, H., Huan, X., Jiang, Q., Wu, Z., Yan, C., Xi, J., Zhao, C., Feng, H., and Luo, S. (2024). Efgartigimod as a promising add-on therapy for myasthenic crisis: A prospective case series. Front. Immunol., 15.","DOI":"10.3389\/fimmu.2024.1418503"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1111\/ncn3.12813","article-title":"Effective efgartigimod treatment for severe thymoma-associated myasthenia gravis experiencing myasthenic crisis: A case report","volume":"12","author":"Morita","year":"2024","journal-title":"Neurol. Clin. Neurosci."},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Ohara, H., Kikutsuji, N., Iguchi, N., and Kinoshita, M. (2024). Efgartigimod combined with steroids as a fast-acting therapy for myasthenic crisis: A case report. BMC Neurol., 24.","DOI":"10.1186\/s12883-024-03804-y"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"e16306","DOI":"10.1111\/ene.16306","article-title":"Overcoming therapeutic challenges: Successful management of a supposedly triple seronegative, refractory generalized myasthenia gravis patient with efgartigimod","volume":"31","author":"Sorrenti","year":"2024","journal-title":"Eur. J. Neurol."},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Shi, F., Chen, J., Feng, L., Lai, R., Zhou, H., Sun, X., Shen, C., Feng, J., Feng, H., and Wang, H. (2024). Efgartigimod treatment in patients with anti-MuSK-positive myasthenia gravis in exacerbation. Front. Neurol., 15.","DOI":"10.3389\/fneur.2024.1486659"},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Shelly, S. (2025). Case report: Successful perioperative intervention with efgartigimod in a patient in myasthenic crisis. Front. Immunol., 16.","DOI":"10.3389\/fimmu.2025.1524200"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"17562864241307687","DOI":"10.1177\/17562864241307687","article-title":"First line treatment with subcutaneous efgartigimod in impending myasthenic crisis: A case report","volume":"17","author":"Kwiedor","year":"2024","journal-title":"Ther. Adv. Neurol. Disord."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1056\/NEJMoa1311084","article-title":"Genetic variants in C5 and poor response to eculizumab","volume":"370","author":"Nishimura","year":"2014","journal-title":"N. Engl. J. Med."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"3125","DOI":"10.1007\/s00415-021-10428-6","article-title":"Complement inhibition initiated recovery of a severe myasthenic crisis with COVID-19","volume":"268","author":"Stankovic","year":"2021","journal-title":"J. Neurol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1002\/mus.27326","article-title":"The use of eculizumab in ventilator-dependent myasthenia gravis patients","volume":"64","author":"Usman","year":"2021","journal-title":"Muscle Nerve"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"6152","DOI":"10.1007\/s00415-022-11222-8","article-title":"Eculizumab as a fast-acting rescue therapy in a refractory myasthenic crisis: A case report","volume":"269","author":"Strano","year":"2022","journal-title":"J. Neurol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"3707","DOI":"10.1007\/s10072-023-06900-y","article-title":"Starting eculizumab as rescue therapy in refractory myasthenic crisis","volume":"44","author":"Vinciguerra","year":"2023","journal-title":"Neurol. Sci."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"17562864241261602","DOI":"10.1177\/17562864241261602","article-title":"The safety and efficacy profile of eculizumab in myasthenic crisis: A prospective small case series","volume":"17","author":"Song","year":"2024","journal-title":"Ther. Adv. Neurol. Disord."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"3299","DOI":"10.1007\/s10072-025-08128-4","article-title":"Prominent and fast response to eculizumab in myasthenic crisis: The potential as rescue therapy in refractory myasthenia gravis","volume":"46","author":"Messina","year":"2025","journal-title":"Neurol. Sci."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.1007\/s12028-025-02237-w","article-title":"Eculizumab as a rescue therapy in prolonged myasthenic crisis in the intensive care unit: A case series","volume":"42","author":"Durmus","year":"2025","journal-title":"Neurocritical Care"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1007\/s12028-025-02272-7","article-title":"Eculizumab as treatment in refractory impeding and myasthenic crisis: A case series","volume":"43","author":"Erra","year":"2025","journal-title":"Neurocritical Care"},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Rossini, E., Morino, S., Garibaldi, M., Leonardi, L., Tufano, L., Lauletta, A., Forcina, F., Antonini, G., and Fionda, L. (2025). Emergent role of complement inhibitors in myasthenic crisis: Understanding why, when and how. Clin. Neurol. Neurosurg., 109011.","DOI":"10.1016\/j.clineuro.2025.109011"},{"key":"ref_76","first-page":"e74117","article-title":"Successful Control of Myasthenic Crisis After the Introduction of Ravulizumab in Myasthenia Gravis: A Case Report","volume":"16","author":"Uchi","year":"2024","journal-title":"Cureus"}],"container-title":["Neurology International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2035-8377\/17\/10\/163\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:50:26Z","timestamp":1760035826000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2035-8377\/17\/10\/163"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,8]]},"references-count":76,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["neurolint17100163"],"URL":"https:\/\/doi.org\/10.3390\/neurolint17100163","relation":{},"ISSN":["2035-8377"],"issn-type":[{"value":"2035-8377","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,8]]}}}