Background: The advent of multiple novel therapies for patients living with generalized myasthenia gravis (gMG) makes it difficult to select the optimal agent.
Objectives: To assess patient preferences regarding drug attributes that influence the use of novel therapies for gMG.
Methods: A web-based survey was conducted from September–October 2024 in adult patients with moderate-to-severe gMG who were symptomatic in the month prior to survey administration. The importance of various hypothetical drug attributes was quantified using conjoint analysis, including administration route/location and frequency; number of injections per dose; continuous vs intermittent treatment course; improvement in Myasthenia Gravis Activities of Daily Living (MG-ADL) score at 12 weeks; timing of response effects; proportion of responders at 12 weeks; and vaccination/monitoring requirements. Part-worth utility of attribute levels in various simulated scenarios were calculated.
Results: A total of 173 patients completed the survey (69% female; mean age, 58.6 years; mean MG-ADL score before current treatment, 11.5); 43% were currently on novel therapies. Patient preferences were primarily driven by level of improvement in MG-ADL, followed by proportion of patients responding within 12 weeks, frequency of treatment administration, and route/location of administration. These attributes, particularly treatment modalities featuring at-home autoinjector administration, garnered higher preference for the drug profiles of neonatal fragment crystallizable receptor (FCRn) inhibitors than for complement inhibitors. Findings for the remaining drug attributes suggested less of an impact on treatment decisions.
Conclusions: Patients with gMG strongly differentiated between specific levels of improvement in MG-ADL and proportion of responders within 12 weeks of treatment initiation; the option for at-home autoinjector treatment administration also had a significant impact on patient preferences. Shared treatment decision-making should include discussions on patient preferences for these attributes.