Breakthrough Treatment Offers Rapid Relief for Myasthenia Gravis Patients Facing Crisis
A new study from China suggests that Vyvgart (efgartigimod) could be a game-changer for patients with Myasthenia Gravis (MG) experiencing a potentially life-threatening worsening of symptoms known as impending myasthenic crisis (IMC). The research, published in Scientific Reports, indicates Vyvgart may provide faster and more effective relief compared to the standard IVIG treatment.
MG, an autoimmune disease, attacks the communication between nerves and muscles, leading to muscle weakness and fatigue. In severe cases, it can cause breathing difficulties requiring ventilation, a situation classified as a myasthenic crisis. Recognizing IMC early and initiating powerful treatment is crucial to prevent this critical complication.
Traditionally, IVIG and plasmapheresis have been used to combat IMC. IVIG involves delivering antibodies from healthy donors to neutralize the harmful antibodies attacking the nervous system, while plasmapheresis replaces the liquid component of blood with a substitute free of MG-causing antibodies.
This new study, however, focuses on Vyvgart, a medication that targets a protein called the neonatal Fc receptor (FcRn). FcRn protects antibodies from breakdown, effectively prolonging their lifespan. By blocking FcRn, Vyvgart accelerates the degradation of these harmful antibodies, potentially offering a quicker path to symptom relief.
Researchers retrospectively analyzed data from 19 MG patients positive for anti-AChR antibodies who experienced IMC. Nine patients received Vyvgart, while ten received IVIG. Both groups were taking pyridostigmine, a common MG treatment, and some were also receiving immunosuppressants and corticosteroids.
The study measured the impact of both treatments using two scales: the MG Activities of Daily Living (MG-ADL) and the MG Composite (MGC). The MG-ADL assesses the impact of MG on daily activities, with lower scores representing less impairment and better functioning. The MGC, on the other hand, measures overall disease severity, with higher values indicating more severe symptoms.
Within a week, Vyvgart demonstrated a significantly greater improvement in MG-ADL scores compared to IVIG. This trend continued after four weeks, further reinforcing the potential of Vyvgart. While the difference in MGC scores wasn’t as marked, Vyvgart-treated patients showed a trend towards greater improvement.
"“Overall, these results suggested rapid therapeutic effect of [Vyvgart] and indicated that [it] could be a rescue therapy for IMC or [myasthenic crisis] patients,” the researchers wrote.
Only one Vyvgart patient experienced a mild side effect – an upper respiratory tract infection with fever that resolved within six days with ibuprofen. No other adverse effects were reported.
These findings suggest Vyvgart may be a valuable addition to the arsenal against MG, offering a potentially quicker and safer way to manage IMC and prevent life-threatening complications. “These findings suggest that [Vyvgart] is a treatment option for [impending myasthenic crisis] in addition to IVIG and plasma exchange,” researchers added.
Further research is needed to confirm these promising results and explore the long-term safety and efficacy of Vyvgart for IMC.
Childhood Asthma Rates on the Rise in the US
In a separate study published in the Journal of Allergy and Clinical Immunology, researchers found a concerning increase in childcare asthma diagnoses in the U.S. between 2001 and 2017.
Dr. Rachel J. Whitaker, lead author of the study and a fellow at the Center for Childhood Obesity Research at the University of Texas McGovern Medical School, said estimated prevalence of childhood asthma is increasing across the U.S., with substantial variations between regions and demographics.
While the reasons behind this rise remain complex, researchers point to a potential link between environmental factors and changes in lifestyle.
"These findings highlight the urgent need for public health interventions to address the increasing burden of childhood asthma," said Dr. Whitaker.
Access to affordable healthcare, air pollution control measures, and policies aimed at promoting healthy lifestyles could all play a vital role in tackling this growing health issue.
