Hospitalization Outcomes After Efgartigimod Initiation in Patients with Myasthenia Gravis
A. Gordon Smith1, Pushpa Narayanaswami2, Cynthia Qi3, Neelam Goyal4, Arash Mahajerin3, Renee Campbell3, Matt Jefferson3, Rohit Menon5, Sam Selvaraj5, Mai Sato5, Gil Wolfe6
1Virginia Commonwealth University, 2Beth Israel Deaconess Medical Center, 3argenx, 4Stanford University, 5ZS Associates, 6Univ. At Buffalo, SUNY
Objective:

To compare hospitalization outcomes between the 1-year before and after efgartigimod initiation in patients with myasthenia gravis (MG).

Background:

While significant reduction in hospitalizations and exacerbations after efgartigimod initiation was observed in the ADAPT/ADAPT+ trials, evidence in clinical practice is limited.

Design/Methods:

In this retrospective cohort study, patients with MG who initiated and continued efgartigimod for ≥1-year were identified from an integrated dataset of US medical and pharmacy claims (based on information licensed from IQVIA: Longitudinal Access and Adjudication Data [LAAD] for the period April 2016−January 2024, reflecting estimates of real-world activity [all rights reserved]) and data from the My VYVGART Path patient support program (PSP). Hospitalizations were evaluated based on inpatient claims recorded during 1-year before and after efgartigimod initiation (index date), and further classified. Exacerbations were defined as inpatient encounters with ICD-10 codes for MG with exacerbation. Crises were defined as intensive care unit admissions with ICD-10 codes for acute respiratory failure. Myasthenia Gravis Activities of Daily Living (MG-ADL) scores before (≤90 days) and after (≤365 days) index were obtained from the PSP.

Results:

440 patients were included. Mean (SD) age was 60.6 (15.0) years and 46% (n=201/440) were female. Compared to the 1-year before index, mean hospitalization events were significantly reduced in the year after index by 52% (pre: 0.65, post: 0.31, P<0.05) for all-cause, and by 63% (pre: 0.41, post: 0.15, P<0.05) for MG-specific events. Mean annual MG-specific exacerbations and crises per patient were significantly reduced by 68% (pre: 0.28, post: 0.09, P<0.05) and by 71% (pre: 0.07, post: 0.02, P<0.05), respectively. Among 190 patients (43%) with MG-ADL available, mean (SD) best-follow up scores were significantly reduced after index (8.0 [3.7] to 3.1 [2.5], P<0.05).

Conclusions:

Based on US claims, hospitalizations, exacerbations, and crises were significantly reduced post-efgartigimod initiation, consistent with the ADAPT/ADAPT+ trial.

10.1212/WNL.0000000000211303
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