Treatment Patterns of a United States Generalized Myasthenia Gravis Population: Analysis of Real-World Data

Topic:

Other

Poster Number: P325

Author(s):

Lesley-Ann Miller-Wilson, PhD, Immunovant, Joe Conyers, MSc, Adelphi Real World, Shiva Lauretta Birija, BSc, Adelphi Real World, Ciara Ringland, MSc, Adelphi Real World, Bollington, UK, Hannah Connolly, Adelphi Real World, Gregor Gibson, BSc, Adelphi Real World, Lincy Lal, PharmD, PhD, Immunovant, Inc., Yuriy Edwards, MD, PhD, Immunovant, Inc.

Background: Pharmacological management of generalized myasthenia gravis (gMG) historically involved acetylcholinesterase inhibitors (AChEI), corticosteroids (CS) and non-steroidal immunosuppressive therapies (NSIST). Newer options include neonatal fragment crystallizable receptor (FcRn) inhibitors and complement inhibitors (CI).
Objectives: To describe treatment patterns in patients with gMG.
Methods: Data were drawn from the Adelphi gMG II Disease Specific Programme™, a cross-sectional survey of US neurologists and their gMG patients from February through August 2024. Oversample data were collected on two recently approved treatments, efgartigimod and ravulizumab. All patients prescribed any gMG treatment were included.
Results: Fifty-two neurologists provided data on 359 patients with gMG (52.4% male; 82.7% White; mean [SD] age, 55.4 [13.7] years). Patients had a mean (SD) time since diagnosis of 3.9 (5.1) years and a mean (SD) Myasthenia Gravis-Activities of Daily Living score of 4.5 (3.4). From diagnosis until the time of the survey, 43.7% of patients were prescribed only first-line treatment for their gMG (most common first-line regimens: AChEI monotherapy [21.7%], AChEI and CS [16.6%], NSIST monotherapy [8.7%]); 33.7% were prescribed second-line therapy (most common second-line regimens: AChEI and NSIST [11.9%], AChEI and CS [10.9%], AChEI and FcRn inhibitors [9.9%]); and 22.6% were prescribed third-line or later-line treatments (most common third-line or later regimens: CI monotherapy [11.1%], FcRn inhibitor monotherapy [9.9%], AChEI and FcRn inhibitors [9.9%]). FcRn inhibitors and CI accounted for 16.1%, 36.6%, and 72.8% of prescriptions for first-, second-, and third-line or later-line therapy, respectively. Mean (SD) duration of first-line, second-line, and third-line or later regimens was 2.0 (3.5), 1.8 (2.3) and 1.3 (1.5) years, respectively.
Conclusion: Targeted therapies for gMG, including FcRn inhibitors and CI, were prescribed more frequently in progressively later lines of therapy. The time spent on each line of therapy suggests an unmet need for treatments that provide more sustained disease control.