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Abstract Details

Functional Improvement in Patients With Myasthenia Gravis Following GLP-1/GIP Receptor Agonist Therapy: A Case Series
Neuromuscular and Clinical Neurophysiology (EMG)
P3 - Poster Session 3 (5:00 PM-6:00 PM)
9-010
To describe improvement in functional status in three overweight patients with generalized Myasthenia Gravis (gMG) treated with glucagon-like peptide-1/glucose-dependent insulinotropic polypeptide dual receptor agonists (GLP-1/GIP RA).
Patients with gMG are often overweight due to pre-existing comorbidity, corticosteroid use, and exercise intolerance. Obesity causes systemic inflammation that may contribute to worsened disease activity and fatigue via increased muscle work-load and predisposition to sleep apnea. GLP-1/GIP RA can augment weight loss and reduce markers of inflammation in other disease states, but their impact on gMG outcomes has not been reported. 
We retrospectively evaluated changes in weight, BMI, and functional status, as measured by the Myasthenia Gravis Activities of Daily Living (MG-ADL) scale, in three patients with gMG treated with GLP-1/GIP RA for metabolic indications between 2023-2025.

Case 1: 62-year-old man stable on ravulizumab and pyridostigmine lost 44 lb (BMI 40 to 33.7) after GLP-1/GIP RA with net improvement in MG-ADL from 5 to 3 over one year.

Case 2: 71-year-old woman stable on efgartigimod, mycophenolate, and pyridostigmine lost 28 lb (BMI 47.5 to 42.5) after GLP-1/GIP RA and had consistent MG-ADL improvement from 5 to 2 over two years.

Case 3: 50-year-old woman on pyridostigmine and prednisone 20mg daily lost 40 lb (BMI 29.3 to 21.9) after GLP-1/GIP RA over one year. MG-ADL fluctuated as patient tapered off prednisone, but was stable at one year. This finding was complicated by the addition of mycophenolate.

All patients reported reduced fatigue, more exertion tolerance, and improved well-being with weight loss that preceded improvement in gMG outcomes.
In this small series, treatment with GLP-1/GIP RA was associated with weight loss and subjective functional improvement that did not consistently correlate with immediate change in MG-ADL. Larger controlled studies that also include broader health outcomes are needed to investigate potential mechanism of benefit and impact on gMG.
Authors/Disclosures
Claudia Guerra Hernandez, PA (University of South Florida)
PRESENTER 		Ms. Guerra Hernandez has nothing to disclose.
Jerrica R. Farias, NP (University of South Florida) Ms. Farias has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Argenx. Ms. Farias has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for UCB Biophrama. Ms. Farias has received personal compensation in the range of $500-$4,999 for serving as a Consultant for POCN. Ms. Farias has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for CSL Behring. Ms. Farias has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Argenx. Ms. Farias has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for UCB Biopharma. Ms. Farias has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for CSL Behring. Ms. Farias has a non-compensated relationship as a Member with AANEM AAP 好色先生 Commitee that is relevant to AAN interests or activities. Ms. Farias has a non-compensated relationship as a Member with NEALS APP Committee that is relevant to AAN interests or activities.
Kathleen A. Murray, MD (University of South Florida - JAHVAH) Dr. Murray has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Guidepoint .
I-Hweii A. Chen, MD, PhD, FAAN (University of South Florida) The institution of Dr. Chen has received research support from Healey Center at Massachusetts General Hospital. The institution of Dr. Chen has received research support from General Hospital Corporation. The institution of Dr. Chen has received research support from Argenx.
Clifton L. Gooch, MD, FAAN (University of South Florida) Dr. Gooch has received publishing royalties from a publication relating to health care. Dr. Gooch has received publishing royalties from a publication relating to health care.
Tuan H. Vu, MD (University of South Florida) Dr. Vu has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Dianthus. Dr. Vu has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amgen. Dr. Vu has received personal compensation in the range of $500-$4,999 for serving as a Consultant for NMD Pharma. Dr. Vu has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for ARGENX. Dr. Vu has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Vu 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. Vu has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen (Horizon). Dr. Vu has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Johnson & Johnson. Dr. Vu has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Alexion. Dr. Vu has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for CSL Behring. Dr. Vu has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Argenx. The institution of Dr. Vu has received research support from CSL Behring. The institution of Dr. Vu has received research support from Alexion. The institution of Dr. Vu has received research support from RA Pharma/UCB. The institution of Dr. Vu has received research support from Mass Gen Hospital/Healy Platform Study. The institution of Dr. Vu has received research support from ARGENX. The institution of Dr. Vu has received research support from Horizon/Amgen. The institution of Dr. Vu has received research support from Woolsey Pharma. The institution of Dr. Vu has received research support from CSL Behring. The institution of Dr. Vu has received research support from Cartesian Therapeutics. The institution of Dr. Vu has received research support from Janssen/Johnson & Johnson. The institution of Dr. Vu has received research support from Immunovant. The institution of Dr. Vu has received research support from Regeneron. The institution of Dr. Vu has received research support from Dianthus. The institution of Dr. Vu has received research support from COUR.