Abstract Details

Title C5-Complement Inhibitors Administration for Treatment of Generalized Myasthenia Gravis: A Systematic Review and Meta-analysis

Topic Neuromuscular and Clinical Neurophysiology (EMG)

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

Poster/Presentation
Number 11-007

Objective To evaluate the efficacy of complement inhibitors for treating myasthenia gravis.

Background C5 inhibitors, including eculizumab, zilucoplan, and ravulizumab, have been considered to be beneficial for patients with myasthenia gravis, acting by blocking the formation of the membrane attack complex, consequently reducing damage to neuromuscular junction cells and protecting against degradation of acetylcholine receptors. However, their efficacy for this population remains unclear.

Design/Methods We systematically searched MEDLINE, Scopus and Cochrane databases until September 25, 2024, for Randomized Controlled Trials (RCT’s) investigating the use of eculizumab, zilucoplan, and ravulizumab in comparison with placebo, for the treatment of myasthenia gravis. Data were examined using the Mantel-Haenszel method and 95% CIs. Heterogeneity was estimated using I² statistics, and RStudio, version 4.3.2, was used for statistical analysis.

Results A total of 5 RCT’s and 532 patients were included, of whom 276 (52%) were treated with C5 inhibitors. In this group, 115 (42%) were treated with zilucoplan, 86 (31%) with ravulizumab and 75 (27%) with eculizumab. Compared with placebo, complement inhibitors achieved better rates of Quantitative Myasthenia Gravis decrease (MD -3.52; 95% CI -4.51 to -2.54; P=<0.000001; I² 98%), Myasthenia Gravis-Quality of Life 15 change (MD -4.5; 95% CI -7.85 to -1.14; P=0.0086; I²=99%), Myasthenia Gravis Composite change (MD -3.15; 95% CI -4.08 to -2.22; P<0,000001; I²=71%) and Myasthenia Gravis Activities of Daily Living change (MD -1.87; 95% CI -2.08 to -1.67; P=<0.000001; I²=52%). Additionally, no significant difference was observed in the incidence of headache and diarrhea.

Conclusions Our meta-analysis demonstrates that complement inhibitors exhibited greater efficacy than placebo across multiple scores of myasthenia gravis treatment. Furthermore, they did not present significant side effects.

Authors/Disclosures
Artur Menegaz de Almeida, MS PRESENTER	Mr. Menegaz de Almeida has nothing to disclose.
João F. Lapenda	Mr. Lapenda has nothing to disclose.
Ana Mattos	Miss Mattos has nothing to disclose.
Paulo V. Albuquerque	Mr. Albuquerque has nothing to disclose.
Lucas A. Araujo	Mr. Araujo has nothing to disclose.
Beatriz Mattos	Miss Mattos has nothing to disclose.
Andre G. Knopp, Student	Mr. Knopp has nothing to disclose.
Felipe L. Campos	Mr. Campos has nothing to disclose.
Maria F. Ferreira, Student	Miss Ferreira has nothing to disclose.
Camillo Farias	Mr. Farias has nothing to disclose.
Ana Laura Soares Silva, Medical Student	Ms. Soares Silva has nothing to disclose.

��ɫ��

��ɫ��