Inebilizumab

Um, and she, uh, was started on prednisone and azathioprine and continued to have symptoms and her MG-ADL, uh, is, uh, of eight.

Um, which of the following, uh, targeted therapy approach would be, uh, best supported, uh, by the available evidence? Uh, eculizumab, um- Efgartigimod, uh, inebilizumab, uh, or zilucoplan or, um, sticking to, um, what we still have her on.

In this case, I would choose efgartigimod.

It is an FCRN antagonist, and the results that we, um, have seen from the ADAPT-CERON study, uh, show that there's efficacy across, uh, MG subtypes.

Um, in 2017, we had the med- first medication, which was, uh, eculizumab, is, uh, it is a complement inhibitors.

And since then we have had, um, five others medications, um, in terms of, uh, downstream therapy, uh, including two other complement inhibitors and three FcRn antagonists, and we'll talk about that shortly.

Um, and, uh, now we have, uh, since December of 2025, a, uh, B cell, B cell, uh, directed, uh, medication called inebilizumab, which is directed against, uh, B cell with, uh, CD19 markers.

Before I go into the clinical trials, um, that led to the approval of these medications, uh, let me briefly go through the two instruments that we use to measure efficacy in, uh, clinical trials.

Um, and she, uh, was started on prednisone and azathioprine and continued to have symptoms and her MG ADL, uh, is, uh, of eight.

Um, which of the following, uh, targeted therapy approach would be, uh, best supported, uh, by the available evidence? Uh, eculizumab, um- Efgartigimod, uh, inebilizumab, uh, or zilucoplan or, um, sticking to, um, what we still have her on.

In this case, I would choose efgartigimod.

It is an FCR antagonist, and the results that we, um, have seen from the ADAPT-CERM study, uh, show that there's efficacy across, uh, MG subtypes.

Is, uh, it is a complement inhibitors.

And since then we have had, um, five others medications, um, in terms of, uh, downstream therapy, uh, including two other complement inhibitors and three FcRn antagonists, and we'll talk about that shortly.

Um, and, uh, now we have, uh, since December of 2025, a, uh, B cell, B cell, uh, directed, uh, medication called inebilizumab, which is directed against, uh, B cell with, uh, CD19 markers.

Before I go into the clinical trials, um, that led to the approval of these medications, uh, let me briefly go through the two instruments that we use to measure efficacy in, uh, clinical trials.

Um, in 2017, we had the med-- first medication, which was, uh, eculizumab, is, uh, it is a complement inhibitors, and since then we have had, um, five others medications, um, in terms of, uh, downstream therapy, uh, including two other complement inhibitors and three FcRn antagonists, and we'll talk about that shortly.

Um, and, uh, now we have, uh, since December of 2025, a, uh, B cell, B cell, uh, directed, uh, medication called inebilizumab, which is directed against, uh, B cell with, uh, CD19 markers.

Before I go into the clinical trials, um, that led to the approval of these medications, uh, let me briefly go through the two instruments that we use to measure efficacy in, uh, clinical trials.

Um, the first one is the MG-ADL, and it is a patient-reported outcome, and it asks the patient, "Over the last seven days, have you had any problems with any of these functions?" And that, uh, those functions are listed on the left side here.

Uh, in terms of, uh, other side effects, uh, headaches and upper respiratory tract infection, diarrhea, nausea, make up the most common, uh, side effects, and they're fairly tolerable.

Nobody, uh, actually stopped the medication because of other symptoms.

In December of, um, twenty twenty-five, we actually got the first, um, medication that's considered upstream, um, treatment for GMG, and that was, uh, inebilizumab.

It is a s- uh, anti-CD19, um, monoclonal antibodies, and it is, uh, approved for both ACHR and Musc antibodies in adults.