Federico II University of Naples, Naples, Italy.
Prosserman Centre for Neuromuscular Diseases, Toronto General Hospital/UHN, Toronto, ON, Canada.
J Neurol. 2023 Apr;270(4):2096-2105. doi: 10.1007/s00415-022-11517-w. Epub 2023 Jan 4.
There are substantial disease and health-related quality-of-life (HRQoL) burdens for many patients with myasthenia gravis (MG), especially for those whose disease symptoms are not well controlled. HRQoL measures such as the Myasthenia Gravis Quality of Life 15-item revised (MG-QOL15r) and EuroQoL 5-Dimensions 5-Levels (EQ-5D-5L) are vital for evaluating the clinical benefit of therapeutic interventions in patients with MG, as they assess the burden of disease and the effectiveness of treatment, as perceived by patients. The phase 3 ADAPT study (NCT03669588) demonstrated that efgartigimod-a novel neonatal Fc receptor inhibitor-was well tolerated and that acetylcholine receptor antibody-positive (AChR-Ab+) participants who received efgartigimod had statistically significant improvements in MG-specific clinical scale scores. The ancillary data reported here, which cover an additional treatment cycle, show that these participants had similar significant improvements in HRQoL measures, the MG-QOL15r and EQ-5D-5L utility and visual analog scales, and that these improvements were maintained in the second treatment cycle. Positive effects on HRQoL were rapid, seen as early as the first week of treatment in both treatment cycles, and maintained for up to 4 weeks in the follow-up-only portion of treatment cycles. The pattern of improvements in HRQoL paralleled changes in immunoglobulin G level, and correlational analyses show that improvements were consistent across HRQoL measures and with clinical efficacy measures in the ADAPT study. The substantial and durable improvements in HRQoL end points in this study demonstrate the broader benefit of treatment with efgartigimod beyond relief of immediate signs and symptoms of gMG.
对于许多重症肌无力(MG)患者来说,存在大量与疾病相关的健康相关生活质量(HRQoL)负担,尤其是那些疾病症状控制不佳的患者。MG-QOL15r 和 EQ-5D-5L 等 HRQoL 测量方法对于评估治疗干预对 MG 患者的临床获益至关重要,因为它们评估了疾病负担和患者感知到的治疗效果。III 期 ADAPT 研究(NCT03669588)表明,efgartigimod-一种新型的新生儿 Fc 受体抑制剂-具有良好的耐受性,并且接受 efgartigimod 的乙酰胆碱受体抗体阳性(AChR-Ab+)参与者在 MG 特异性临床量表评分方面具有统计学意义的改善。这里报告的辅助数据涵盖了额外的治疗周期,表明这些参与者在 HRQoL 测量、MG-QOL15r 和 EQ-5D-5L 效用和视觉模拟量表方面也有类似的显著改善,并且这些改善在第二个治疗周期中得以维持。对 HRQoL 的积极影响是迅速的,在两个治疗周期中,从治疗的第一周就可见到,在治疗周期的随访部分中可维持长达 4 周。HRQoL 改善的模式与免疫球蛋白 G 水平的变化相平行,相关性分析表明,改善在 ADAPT 研究中与 HRQoL 测量和临床疗效测量一致。本研究中 HRQoL 终点的显著和持久改善表明,efgartigimod 的治疗除了缓解 gMG 的即时体征和症状外,还具有更广泛的益处。