Double-Filtration Plasmapheresis Versus Efgartigimod for Generalized Myasthenia Gravis: Severity-Stratified Benefits in a Prospective Observational Multicenter Study - PubMed
5 hours ago
- #generalized myasthenia gravis
- #double-filtration plasmapheresis
- #efgartigimod
- Comparison of Double-Filtration Plasmapheresis (DFPP) and efgartigimod (EFG) for treating generalized myasthenia gravis (gMG).
- Prospective multicenter study from Aug 2019-Mar 2025 involving 66 gMG patients (41 EFG, 25 DFPP).
- Primary endpoints: Changes in QMG and MG-ADL scores at baseline (T0), post-treatment (T1), and 1 month post-treatment (T2).
- DFPP showed superior efficacy in moderate-to-severe gMG (MGFA ≥ IIb) compared to EFG at T2.
- Efficacy was comparable in mild cases (MGFA ≤ IIa).
- 5-session DFPP had higher sustained clinical meaningful improvement (CMI) rates (85%) vs. 3-session DFPP (45%) and EFG (70%).
- DFPP broadly reduced immunoglobulins/complement, while EFG selectively reduced IgG.
- Adverse events: 28.0% in DFPP (mainly catheter-related thrombosis) vs. 39.0% in EFG (predominantly headache).
- Conclusion: Both treatments are effective, but DFPP is more beneficial for moderate-to-severe gMG, highlighting the need for individualized therapy.