Abstract Details

Title Hospitalization Outcomes After Efgartigimod Initiation in Patients with Myasthenia Gravis

Topic Neuromuscular and Clinical Neurophysiology (EMG)

Presentation(s) P1 - Poster Session 1 (11:45 AM-12:45 PM)

Poster/Presentation
Number 11-011

Objective

To compare hospitalization outcomes between the 1-year before and after efgartigimod initiation in patients with myasthenia gravis (MG).

Background

While significant reduction in hospitalizations and exacerbations after efgartigimod initiation was observed in the ADAPT/ADAPT+ trials, evidence in clinical practice is limited.

Design/Methods

In this retrospective cohort study, patients with MG who initiated and continued efgartigimod for ≥1-year were identified from an integrated dataset of US medical and pharmacy claims (based on information licensed from IQVIA: Longitudinal Access and Adjudication Data [LAAD] for the period April 2016−January 2024, reflecting estimates of real-world activity [all rights reserved]) and data from the My VYVGART Path patient support program (PSP). Hospitalizations were evaluated based on inpatient claims recorded during 1-year before and after efgartigimod initiation (index date), and further classified. Exacerbations were defined as inpatient encounters with ICD-10 codes for MG with exacerbation. Crises were defined as intensive care unit admissions with ICD-10 codes for acute respiratory failure. Myasthenia Gravis Activities of Daily Living (MG-ADL) scores before (≤90 days) and after (≤365 days) index were obtained from the PSP.

Results

440 patients were included. Mean (SD) age was 60.6 (15.0) years and 46% (n=201/440) were female. Compared to the 1-year before index, mean hospitalization events were significantly reduced in the year after index by 52% (pre: 0.65, post: 0.31, P<0.05) for all-cause, and by 63% (pre: 0.41, post: 0.15, P<0.05) for MG-specific events. Mean annual MG-specific exacerbations and crises per patient were significantly reduced by 68% (pre: 0.28, post: 0.09, P<0.05) and by 71% (pre: 0.07, post: 0.02, P<0.05), respectively. Among 190 patients (43%) with MG-ADL available, mean (SD) best-follow up scores were significantly reduced after index (8.0 [3.7] to 3.1 [2.5], P<0.05).

Conclusions

Based on US claims, hospitalizations, exacerbations, and crises were significantly reduced post-efgartigimod initiation, consistent with the ADAPT/ADAPT+ trial.

Authors/Disclosures
Cynthia Qi (argenx) PRESENTER	Cynthia Qi has received personal compensation for serving as an employee of argenx.
A. Gordon Smith, MD, FAAN (VCU Health System Department of Neurology)	Dr. Smith has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. Dr. Smith has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Argenx. Dr. Smith has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merz. Dr. Smith has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sangamo. Dr. Smith has received personal compensation in the range of $500-$4,999 for serving as a Consultant for US Department of Justice. Dr. Smith has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen. Dr. Smith has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Eidos. Dr. Smith has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Lexicon. Dr. Smith has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alexion. The institution of Dr. Smith has received research support from NIH (NINDS, NIDDK). Dr. Smith has received publishing royalties from a publication relating to health care. Dr. Smith has received personal compensation in the range of $0-$499 for serving as a Study Section with NIH.
Pushpa Narayanaswami, MD, MBBS, FAAN (Beth Israel Deaconess Medical Center)	Dr. Narayanaswami has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for UCB. Dr. Narayanaswami has received personal compensation in the range of $500-$4,999 for serving as a Consultant for CVS. Dr. Narayanaswami has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Narayanaswami has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Janssen. Dr. Narayanaswami has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Argenx USA. Dr. Narayanaswami has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Narayanaswami has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Argenx. Dr. Narayanaswami has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for NMD pharma. Dr. Narayanaswami has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD-Serono (Merck usa). Dr. Narayanaswami has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Immuneabs. Dr. Narayanaswami has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Viridian. Dr. Narayanaswami has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Cabaletta-Bio. Dr. Narayanaswami has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Immunovant. Dr. Narayanaswami has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen. Dr. Narayanaswami has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Dianthus. Dr. Narayanaswami has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Cartesian. Dr. Narayanaswami has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Vor Bio. Dr. Narayanaswami has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Muscle and Nerve, Wiley. Dr. Narayanaswami has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurology. Dr. Narayanaswami has or had stock in Dr. Reddys laboratories.Dr. Narayanaswami has or had stock in Doximity. The institution of Dr. Narayanaswami has received research support from Alexion. The institution of Dr. Narayanaswami has received research support from NIH. The institution of Dr. Narayanaswami has received research support from Argenx. The institution of Dr. Narayanaswami has received research support from Cabaletta Bio. Dr. Narayanaswami has received publishing royalties from a publication relating to health care. Dr. Narayanaswami has a non-compensated relationship as a Member, Finance Committee with AANEM that is relevant to AAN interests or activities.
Neelam Goyal, MD, FAAN (Stanford University)	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.
Arash Mahajerin, MD, MSCr	Dr. Mahajerin has received personal compensation for serving as an employee of argenx. Dr. Mahajerin has stock in argenx.
Renee Campbell, MD	Dr. Campbell has received personal compensation for serving as an employee of argenx. Dr. Campbell has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for Guidehouse.
Matt Jefferson	Matt Jefferson has received personal compensation for serving as an employee of argenx. Matt Jefferson has stock in argenx.
Rohit Menon	Rohit Menon has received personal compensation for serving as an employee of ZS Associates.
Sam Selvaraj, Bachelor of Technology	Mr. Selvaraj has received personal compensation for serving as an employee of ZS Associates.
Mai Sato, PhD	Dr. Sato has received personal compensation for serving as an employee of ZS Associates.
Gil I. Wolfe, MD, FAAN (Univ. At Buffalo, SUNY)	Dr. Wolfe has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Grifols. Dr. Wolfe has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Alexion. Dr. Wolfe has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for ArgenX. Dr. Wolfe has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for UCB/Ra. Dr. Wolfe has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen. Dr. Wolfe has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Cartesian. Dr. Wolfe has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Grifols. The institution of Dr. Wolfe has received research support from UCB/Ra. The institution of Dr. Wolfe has received research support from Immunovant. The institution of Dr. Wolfe has received research support from Roche. Dr. Wolfe has received personal compensation in the range of $0-$499 for serving as a Advisor with FDA Advisory Panel for Cellular, Tissue and Genetic Therapies.

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