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Abstract Details

Real-world Treatment Patterns Among Patients with Generalized Myasthenia Gravis
Neuromuscular and Clinical Neurophysiology (EMG)
P6 - Poster Session 6 (11:45 AM-12:45 PM)
11-027
To evaluate real-world treatment patterns and myasthenia gravis (MG)-related clinical events among patients with generalized MG (gMG) in the US.
gMG is a rare chronic autoimmune condition. Conventional treatments include acetylcholinesterase inhibitors (AChEI), corticosteroids, and non-steroidal immunosuppressants. Newly approved targeted therapies include neonatal Fc receptor (FcRn) and complement-5 (C5) inhibitors. Knowledge of real-world treatment patterns with currently available therapies and MG-related clinical events is limited.
Adults with gMG were identified from the Komodo Research Database (01/2017-09/2023). Index date was the first MG diagnosis by a neurologist. Baseline (12-months pre-index) demographic characteristics, follow-up (≥12 months post-index) treatment patterns, including first 5 observed treatment episodes, MG exacerbations and crises were described.
6,195 patients were included (mean age: 61.1 years; female: 49.1%; mean follow-up: 32.7 months). Among those receiving treatments, from the first episode (n=5,652) to the fifth episode (n=2,107): AChEI use declined from 81.1% to 58.5%; corticosteroid use fluctuated between 48.2-63.2%, and use of the following treatments increased: any non-steroidal immunosuppressants (11.8% to 41.8%), any immunoglobulin (6.3% to 15.6%), FcRn inhibitors (0.1% to 2.7%), and C5 inhibitors (0.2% to 2.9%). Mean time from index date to FcRn initiation was 20.7 months and to C5 inhibitors initiation 15.8 months. Post-index, 48.8% and 3.1% of patients had MG exacerbation or crisis, respectively. Exacerbations and crises were most common 1-year post-index (41.5%), but declined over time (20.3%, 18.0%, and 14.4% in the second, third, and fourth year, respectively).
Conventional treatments were an initial treatment strategy for most patients in this cohort, while immunoglobulin and targeted treatments were generally used later. This, combined with the high rates of exacerbation and crisis during the first year, highlights an unmet need for treatment strategies that provide stable and sustained disease control earlier in the disease course when managing patients with gMG.
Authors/Disclosures
Kavita M. Grover, MD, FAAN
PRESENTER 		Dr. Grover has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen. Dr. Grover has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UCB. Dr. Grover has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amgen. Dr. Grover has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Kyverna. Dr. Grover has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Argenx. Dr. Grover has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Catalyst.
Kavita Gandhi, MS, BSPharm Ms. Gandhi has received personal compensation for serving as an employee of Johnson and Johnson . Ms. Gandhi has stock in Johnson and Johnson .
Martin Cloutier Mr. Cloutier has received personal compensation for serving as an employee of Analysis Group, Inc..
Geoffroy Coteur, PhD Dr. Coteur has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for Johnson & Johnson.
Maryia Zhdanava Maryia Zhdanava has received personal compensation for serving as an employee of Analysis Group.
Antoine El Khoury, PhD Dr. El Khoury has received personal compensation for serving as an employee of Johnson & Johnson. Dr. El Khoury has stock in Johnson & Johnson.
Porpong Boonmak (Analysis Group, Inc.) Porpong Boonmak has received personal compensation for serving as an employee of Analysis Group, Inc..
Qian Cai Qian Cai has received personal compensation for serving as an employee of Johnson & Johnson. Qian Cai has stock in Johnson & Johnson.
Anabelle Tardif-Samson Miss Tardif-Samson has received personal compensation for serving as an employee of Analysis Group, Inc..
Maria Ait Tihyaty (Johnson and Johnson Innovative Medicine) Dr. Ait Tihyaty has received personal compensation for serving as an employee of Dianthus Therapeutics.
Yuxi Wang Ms. Wang has received personal compensation for serving as an employee of Analysis Group, Inc..
Zia U. Choudhry, MD, PhD (JOHNSON AND JOHNSON) Dr. Chaudhry has received personal compensation for serving as an employee of Johnson & Johnson. Dr. Chaudhry has received personal compensation for serving as an employee of Takeda Pharmaceuticals.
Nicholas J. Silvestri, MD, FAAN (UBMD Neurology) Dr. Silvestri has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for argenx. Dr. Silvestri has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Regeneron. Dr. Silvestri 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. Silvestri has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB. Dr. Silvestri 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. Silvestri has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen. Dr. Silvestri has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for argenx. Dr. Silvestri has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alexion. The institution of an immediate family member of Dr. Silvestri has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for UCB. Dr. Silvestri has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Takeda. Dr. Silvestri has received publishing royalties from a publication relating to health care.