Department of Neurology, First Hospital of Shanxi Medical University, No.85, Jiefang South Street, Taiyuan, China.
First Clinical Medical College, Shanxi Medical University, Taiyuan, China.
Sci Rep. 2024 Nov 18;14(1):28394. doi: 10.1038/s41598-024-79918-7.
Impending myasthenic crisis (IMC) is an emergent situation requiring aggressive management to prevent patients from developing myasthenic crisis (MC) in patients with myasthenia gravis (MG). Efgartigimod has been proved to be well tolerated and efficacious in MG patients. The present study aimed to compare the efficacy of efgartigimod and intravenous immunoglobulin (IVIg) in rescuing IMC. IMC patients treated with efgartigimod or IVIg were retrospectively enrolled. The primary outcome was determined as the mean change in MG activities of daily living (MG-ADL) score from baseline to week 1 and 4 after treatment, respectively. Safety was assessed based on medical records during the hospitalization to monitor the adverse events. A total of 9 patients treated with efgartigimod and 10 patients treated with IVIg were enrolled. There were no significant differences in the clinical characteristics at baseline between the two groups (P > 0.05). Compared with the IVIg group, the efgartigimod group had a greater reduction in the MG-ADL score at week 1 (P = 0.035) and week 4 (P = 0.005). One patient in the efgartigimod group had an upper respiratory infection. These findings suggest that efgartigimod is a treatment option for IMC in addition to IVIg and plasma exchange.
即将发生的肌无力危象（IMC）是一种紧急情况，需要积极管理，以防止重症肌无力（MG）患者发生肌无力危象（MC）。依氟鸟氨酸已被证明在 MG 患者中具有良好的耐受性和疗效。本研究旨在比较依氟鸟氨酸和静脉注射免疫球蛋白（IVIg）在抢救 IMC 中的疗效。回顾性纳入接受依氟鸟氨酸或 IVIg 治疗的 IMC 患者。主要结局分别为治疗后第 1 周和第 4 周时 MG 日常生活活动（MG-ADL）评分与基线相比的平均变化。安全性根据住院期间的病历评估，以监测不良事件。共纳入 9 例接受依氟鸟氨酸治疗和 10 例接受 IVIg 治疗的患者。两组患者的基线临床特征无显著差异（P>0.05）。与 IVIg 组相比，依氟鸟氨酸组在第 1 周（P=0.035）和第 4 周（P=0.005）时的 MG-ADL 评分降低更显著。依氟鸟氨酸组中有 1 例患者发生上呼吸道感染。这些发现表明，除了 IVIg 和血浆置换之外，依氟鸟氨酸也是 IMC 的治疗选择。
