Abstract Details

Title Real-world Reduction in Oral Corticosteroid Utilization Following Efgartigimod Initiation in Patients Living with Generalized Myasthenia Gravis

Topic Autoimmune Neurology

Presentation(s) S38 - Autoimmune Neurology: Peripheral Autoimmunity, Paraneoplastic Disease, Checkpoint Inhibitors, and Neurosarcoidosis (3:42 PM-3:54 PM)

Poster/Presentation
Number 002

Objective To evaluate real-world utilization of oral corticosteroids (OCS) among patients with generalized myasthenia gravis (gMG) over the first 6 months post-efgartigimod treatment initiation.

Background

Reducing or tapering OCS, a commonly used treatment in gMG, can alleviate the risk of many adverse events related to long-term OCS usage.

Design/Methods In this retrospective cohort study, patients with gMG using OCS who initiated efgartigimod treatment were identified from a US medical and pharmacy claims database (based on information licensed from IQVIA: Longitudinal Access and Adjudication Data [LAAD] for the period April 2016−April 2023, reflecting estimates of real-world activity [all rights reserved]). Average daily dose (ADD) of OCS was analyzed: (1) during the 3-month period immediately prior to efgartigimod initiation, (2) at 3-months post-efgartigimod initiation, and (3) at 6-months post-efgartigimod initiation. The proportion of patients whose ADD changed ≥5 mg between pre- and post-efgartigimod initiation and distribution of ADD at each timepoint were evaluated.

Results Among 576 patients with gMG who initiated efgartigimod between January 2022-September 2022, and continued efgartigimod treatment for ≥6 months, 231 (40%) were using OCS at baseline (pre-efgartigimod) and were included in the study. At baseline, 17 (7.4%), 109 (47.1%), 105 (45.5%) of patients had OCS AAD of 0-5mg, 5-20mg, and >20mg, respectively. At 3-months and 6-months post-efgartigimod, 82 (35%) and 99 (43%) patients experienced ≥5mg reduction in ADD, respectively. The proportion of patients with ADD of 0-5mg increased more than 3-fold (7% at baseline vs. 26% 6-months post-efgartigimod) and the proportion of patients with ADD of >20mg reduced by 35% (45% at baseline vs. 29% 6-months post-efgartigimod) following efgartigimod initiation.

Conclusions While additional data is required to assess longer-term patterns, early insights into OCS utilization post-efgartigimod initiation in patients with gMG indicate that a substantial proportion experienced reduction in OCS usage over the first 6 months post-efgartigimod initiation.

Authors/Disclosures
Neelam Goyal, MD, FAAN (Stanford University) PRESENTER	Dr. Goyal has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Argenx. Dr. Goyal has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for UCB. Dr. Goyal has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Janssen. Dr. Goyal has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. The institution of Dr. Goyal has received research support from Argenx.
Cynthia Qi (argenx)	Cynthia Qi has received personal compensation for serving as an employee of argenx.
John H. Stone, MD, MPH	No disclosure on file
Deborah Gelinas, MD (ARGENX)	Dr. Gelinas has received personal compensation for serving as an employee of argenx. Dr. Gelinas has stock in argenx.
Matt Jefferson	Matt Jefferson has received personal compensation for serving as an employee of argenx. Matt Jefferson has stock in argenx.
Tharun Balaji Suthagar	No disclosure on file
Rohit Menon	Rohit Menon has received personal compensation for serving as an employee of ZS Associates.
Amit Goyal (ZS)	No disclosure on file
Glenn A. Phillips, PhD	Dr. Phillips has received personal compensation for serving as an employee of argenx. Dr. Phillips has stock in argenx.

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