Post-intervention Status in Patients With Refractory Myasthenia Gravis Treated With Eculizumab During REGAIN and Its Open-Label Extension


Por: Mantegazza, R, Wolfe, GI, Muppidi, S, Wiendl, H, Fujita, KP, O'Brien, FL, Booth, HDE, Howard, JF, Illa I., Cortés-Vicente E., Díaz-Manera J., Querol L.A., Rojas-García R., Vidal-Fernandez N., REGAIN Study Group

Publicada: 26 ene 2021
Resumen:
Objective To evaluate whether eculizumab helps patients with anti-acetylcholine receptor-positive (AChR+) refractory generalized myasthenia gravis (gMG) achieve the Myasthenia Gravis Foundation of America (MGFA) post-intervention status of minimal manifestations (MM), we assessed patients' status throughout REGAIN (Safety and Efficacy of Eculizumab in AChR+ Refractory Generalized Myasthenia Gravis) and its open-label extension. Methods Patients who completed the REGAIN randomized controlled trial and continued into the open-label extension were included in this tertiary endpoint analysis. Patients were assessed for the MGFA post-intervention status of improved, unchanged, worse, MM, and pharmacologic remission at defined time points during REGAIN and through week 130 of the open-label study. Results A total of 117 patients completed REGAIN and continued into the open-label study (eculizumab/eculizumab: 56; placebo/eculizumab: 61). At week 26 of REGAIN, more eculizumab-treated patients than placebo-treated patients achieved a status of improved (60.7% vs 41.7%) or MM (25.0% vs 13.3%; common OR: 2.3; 95% CI: 1.1-4.5). After 130 weeks of eculizumab treatment, 88.0% of patients achieved improved status and 57.3% of patients achieved MM status. The safety profile of eculizumab was consistent with its known profile and no new safety signals were detected. Conclusion Eculizumab led to rapid and sustained achievement of MM in patients with AChR+ refractory gMG. These findings support the use of eculizumab in this previously difficult-to-treat patient population.

Filiaciones:
Mantegazza, R:
 Fdn IRCCS Ist Neurol Carlo Besta, Milan, Italy

Wolfe, GI:
 Univ Buffalo State Univ New York, Jacobs Sch Med & Biomed Sci, Dept Neurol, Buffalo, NY USA

Muppidi, S:
 Stanford Univ, Sch Med, Dept Neurol & Neurol Sci, Palo Alto, CA 94304 USA

Wiendl, H:
 Univ Munster, Dept Neurol, Munster, Germany

Fujita, KP:
 Alnylam Pharmaceut, Cambridge, MA USA

 Alex Pharmaceut, Boston, MA USA

O'Brien, FL:
 Alex Pharmaceut, Boston, MA USA

Booth, HDE:
 Oxford PharmaGenesis, Oxford, England

Howard, JF:
 Univ N Carolina, Dept Neurol, Chapel Hill, NC 27515 USA

Illa I.:
 Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain

Cortés-Vicente E.:
 Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain

Díaz-Manera J.:
 Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain

Querol L.A.:
 Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain

Rojas-García R.:
 Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain

Vidal-Fernandez N.:
 Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain
ISSN: 00283878
Editorial
LIPPINCOTT WILLIAMS & WILKINS, TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA, Estados Unidos America
Tipo de documento: Article
Volumen: 96 Número: 4
Páginas: 610-618
WOS Id: 000657546900024
ID de PubMed: 33229455
imagen Green Published, hybrid

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