Ravulizumab for the treatment of myasthenia gravis

IntroductionMyasthenia gravis (MG) is a neurological B-cell mediated autoimmune disorder affecting the neuromuscular junction. MG therapeutics have always relied on nonselective immunosuppression with oral steroids and non-steroidal immunosuppressants, mainly with good clinical response. However, clinical stabilization is often reached at the cost of many troublesome side effects and up to 15% of MG patients are deemed as refractory to conventional immunosuppression. This highlights the need of a more targeted and efficacious therapeutic approach. Results from the randomized-controlled period of the CHAMPION study demonstrate a good safety, tolerability, and efficacy profile of ravulizumab compared to placebo. Like eculizumab, ravulizumab is an anti-C5 monoclonal antibody, but with an enhanced pharmacokinetic profile, that allows dosing every 8 weeks.Areas coveredWe provide an overview of ravulizumab biological features and results from the phase III CHAMPION MG (NCT03920293) study.Expert opinionData of the CHAMPION MG trial demonstrate that ravulizumab is effective and safe in the treatment of generalized MG. Having a rapid clinical effect, with long-term clinical response, ravulizumab could represent a selective immunosuppressive drug of choice in the future therapeutic algorithm of MG, where conventional immunosuppressants slowly leave room for newer drugs with a more targeted mechanism of action.

Automated summary

Myasthenia gravis (MG) is an autoimmune disorder affecting the neuromuscular junction. Current treatments rely on nonselective immunosuppression, but have significant side effects and some patients are refractory. Ravulizumab, a selective immunosuppressive drug, has shown promising results in a randomized-controlled study (CHAMPION MG).