Transitioning Patients With Generalized Myasthenia Gravis From Eculizumab to Ravulizumab: Effectiveness and Safety From the MG501 Registry


Clinical Management

Poster Number: M263


Andrew Gordon, MD, Northwest Neurology, LTD, Lake Barrington, IL, USA, Pushpa Narayanaswami, MD, FAAN, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA, Michael Pulley, MD, PhD, University of Florida, Jacksonville, FL, USA, Saida Sharapova, MD, MPH, CPH, Alexion, AstraZeneca Rare Disease, Boston, MA, USA, Guido Sabatella, MD, Alexion, AstraZeneca Rare Disease, Boston, MA, USA, James Howard, MD, University of North Carolina, Chapel Hill

Background: Complement component 5 inhibitors eculizumab and ravulizumab are approved treatments for generalized myasthenia gravis (gMG) and are dosed every 2 weeks (Q2W) and 8 weeks (Q8W), respectively. The MG501 registry collects data on eculizumab and ravulizumab effectiveness and safety.
Objective: To assess the effectiveness and safety of transitioning patients with gMG from eculizumab to ravulizumab in clinical practice using the Myasthenia Gravis Activities of Daily Living (MG-ADL) total score and Myasthenia Gravis Foundation of America (MGFA) classification.
Methods: Registry patients who transitioned from eculizumab to ravulizumab were included if they had MG-ADL total scores and MGFA classifications before initiating and during eculizumab treatment, and after transitioning to ravulizumab treatment. Descriptive statistics were performed and are presented as mean (standard deviation). Safety data will be reported.
Results: Of the 188 registry patients enrolled, 38 (20%; 66% male) transitioned from eculizumab to ravulizumab. Patient age at eculizumab and ravulizumab initiation was 65.1 (15.4) and 68.0 (16.0) years, respectively. For 16 patients with MG-ADL total scores, a 4.2-point reduction from 8.1 (4.0) to 3.9 (4.5) was observed after 31.5 (22.4) months of eculizumab treatment. After transitioning to ravulizumab, MG-ADL total scores remained stable at 3.3 (3.6) after 5.2 (2.2) months of treatment. In patients with MGFA classifications, improvements were noted during eculizumab treatment and remained stable over 5.3 (2.3) months after transitioning to ravulizumab.
Conclusions: These initial results from the MG501 registry, representing clinical practice, demonstrate that average improvements achieved during Q2W eculizumab treatment were maintained when patients with gMG transitioned to Q8W ravulizumab.
Previously presented at AANEM, 2023. Gordon A, et al. Neurology. 2023;100(17 suppl 2):2183. Reused with permission.