To descriptively compare clinical burden, quality of life, comorbidities, and healthcare resource utilization (HRU) among U.S. myasthenia gravis (MG) patients enrolled in the MGFA Global MG Patient Registry (MGFAPR) across two time periods: before and after biologic availability.

The analysis included 2,926 adults from MGFAPR, comprising 2,203 in Cohort A and 723 in Cohort B. Mean age at enrollment was 58.0 (SD 15.2) in Cohort A and 59.3 (SD 15.3) in Cohort B, and women comprised 62% and 63% of each cohort, respectively. Biologic use remained modest (Cohort A: 1.6%, Cohort B: 11.0%) and steroid use remained high around 40% in both cohorts; intravenous immunoglobulin (IVIg) (Cohort A: 17%, Cohort B: 27%) and plasma exchange (PLEX) (Cohort A: 5%, Cohort B: 9%) significantly increased.

Clinical burden remained elevated as measured by significantly higher MG-ADL scores (Cohort A: 5.45, Cohort B: 6.12). Quality of life as measured by MG-QoL15r showed no statistical difference. Psychosocial, autoimmune, and cardiovascular comorbid burden significantly increased. HRU was significantly higher in Cohort B (p<0.001) as observed by ER visits (Cohort A: 12%, Cohort B: 19%) and hospitalizations (Cohort A: 8%, Cohort B: 14%). Differences across cohorts persisted, even after matched analyses.

In this large U.S. registry, patient-reported burden remained substantial in 2020–2024, despite the availability of new targeted therapies, as compared to 2013–2017. While the uptake of new therapies was limited, these findings highlight growing unmet needs and opportunities to further optimize and improve disease management.