Abstract Details

Title Comparing the Safety and Efficacy of Myasthenia Gravis Treatments: A Bayesian Network Meta-analysis Accounting for Inconsistencies in Trial Designs and Populations

Topic Neuromuscular and Clinical Neurophysiology (EMG)

Presentation(s) P11 - Poster Session 11 (11:45 AM-12:45 PM)

Poster/Presentation
Number 9-019

Objective We compared the efficacy and safety of myasthenia gravis (MG) treatments leveraging a Bayesian hierarchical model accounting for the inconsistencies in trial designs and populations.

Background In the last decade, many novel targeted therapies have shown promise in treating generalized MG; however, no head-to-head prospective studies have compared efficacy and safety between one another, nor to existing therapies. As a viable alternative, we conducted a Bayesian network meta-analysis, designed to account for inconsistencies in study designs and populations.

Design/Methods Twenty-seven trials (publication date range: 1987-2025; placebo n=1,086; treatment n=1,232) reporting change from baseline in MG-Activities of Daily Living (MG-ADL) or Quantitative MG (QMG) score, targeting B-Cells, neonatal Fc receptor (FcRn), complement activity, CD40, Interleukin-6 signaling, immunoglobulin G, and broadscale immunosuppression were included.

Results QMG scores decreased by an average of -3.6 (95% Credible Interval: [-4.40, -2.72]) points more in patients treated with FcRn inhibitors than those treated with placebo/standard of care, followed by -2.59 [-3.93, -1.27] points for C5 complement inhibitors, and -2.50 [-5.15, 0.13] points for CD19 Depletion. MG-ADL scores decreased by -1.94 [-2.23, -1.67] in patients treated with FcRn inhibitors, -1.89 [-2.95, -0.83] for CD19 Depletion, and -1.78 [-2.43, -1.13] for C5 complement inhibitors. These results remained consistent in sensitivity analyses. In simulations, FcRn inhibitors had a probability of 0.873 of having the greatest QMG treatment effect and 0.834 for MG-ADL. Patients treated with FcRn inhibitors had greater odds of treatment-related adverse events (Odds Ratio: 2.20 [1.52, 3.38]) while C5 complement inhibitors and CD19 depletion showed comparable odds to placebo/standard of care.

Conclusions This meta-analysis cannot substitute randomized trials, but compares the benefits and adverse events of targeted therapies and will help make evidence-based therapeutic choices in MG.

Authors/Disclosures
Bhaskar Roy, MD, FAAN (Yale University) PRESENTER	Dr. Roy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for argenx. Dr. Roy has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. Dr. Roy has stock in Cabaletta bio. . Dr. Roy has stock in Pfizer. Dr. Roy has stock in CAVA. The institution of Dr. Roy has received research support from Abcuro Pharmaceuticals. The institution of Dr. Roy has received research support from Immunovant. The institution of Dr. Roy has received research support from argenx.
Nilay McLaren	Mr. McLaren has nothing to disclose.
Wayne Zhong, MD	Dr. Zhong has nothing to disclose.
Sheena Hussain	Miss Hussain has nothing to disclose.
Richard J. Nowak, MD (Yale University School of Medicine)	Dr. Nowak has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion . Dr. Nowak has received personal compensation in the range of $500-$4,999 for serving as a Consultant for argenx. Dr. Nowak has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UCB. Dr. Nowak has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Immunovant . Dr. Nowak has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cabaletta Bio . Dr. Nowak has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Amgen. Dr. Nowak has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cour Pharma. Dr. Nowak has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono. Dr. Nowak has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janseen . The institution of Dr. Nowak has received research support from UCB. The institution of Dr. Nowak has received research support from Alexion . The institution of Dr. Nowak has received research support from Janseen. The institution of Dr. Nowak has received research support from Immunovant . The institution of Dr. Nowak has received research support from argenx. The institution of Dr. Nowak has received research support from Amgen. Dr. Nowak has a non-compensated relationship as a Member of the Board of Directors with Myasthenia Gravis Foundation of America (MGFA) that is relevant to AAN interests or activities.

��ɫ��

��ɫ��