Background: Matching-adjusted indirect comparisons (MAICs) can assess treatment benefits for symptom control in patients with generalized myasthenia gravis (gMG).
Objective: Building on previous comparisons of ravulizumab and efgartigimod, we performed a MAIC using mean changes from baseline in Myasthenia Gravis Activities of Daily Living (MG-ADL) scores from the CHAMPION-MG and ADAPT trials to assess the effects of these treatments on symptom control at different timepoints in patients with gMG.
Methods: Individual patient-level data from CHAMPION-MG were weighted to match summary baseline characteristics from the acetylcholine receptor antibody–positive subset of patients in ADAPT at the trial-arm level. Mean changes in MG-ADL scores from baseline to different timepoints were compared, and anchored comparisons were performed at weeks 4 and 10, and at week 8 (efgartigimod) vs week 26 (ravulizumab).
Results: Patients from CHAMPION-MG (N = 175) and ADAPT (N = 129) were included, with similar baseline characteristics across both studies. Improvements in MG-ADL scores varied across timepoints and appeared to favor efgartigimod vs ravulizumab at week 4 (mean MG-ADL change from baseline, −1.6; 95% confidence interval [CI], −3.0 to −0.3). However, at week 10 (mean change from baseline, 1.0; 95% CI, −0.5 to 2.5), and at week 8 (efgartigimod) vs week 26 (ravulizumab; mean change from baseline, 1.2; 95% CI, −0.2 to 2.7), the results trended in favor of ravulizumab.
Conclusions: Outcomes from indirect comparisons of symptom control in patients with gMG treated with ravulizumab vs efgartigimod can vary depending on timepoints and matching methodology. Consistency of symptom control over a prolonged period should be considered, alongside efficacy and tolerability, when assessing treatments for gMG.
Previously presented at EAN, 2023. Meuth S, et al. Eur J Neurol. 2023;30(suppl 1):467. Reused with permission.