Real-World Efficacy and Safety of Inebilizumab in Generalized Myasthenia Gravis
Huining Li1, Chao Zhang1, Dongmei Jia1, Jing Pan1, Ti Wu1
1Department of Neurology, Tianjin Medical University General Hospital
Objective:
To evaluate the real-world efficacy and safety of inebilizumab in patients with generalized myasthenia gravis (gMG).
Background:
Autoimmune gMG is characterized by fluctuating muscle weakness driven by pathogenic autoantibodies. Inebilizumab, a humanized monoclonal antibody targeting CD19, induces broad B-cell depletion and may mitigate disease activity by eliminating antibody-secreting cells, which are central to disease pathogenesis.
Design/Methods:
We retrospectively analyzed five patients with gMG (three acetylcholine receptor antibody-positive and two muscle-specific kinase antibody-positive) who received inebilizumab over a 15-month period. Concomitant glucocorticoids were tapered to a target dose of 5 mg/day. Clinical outcomes—including Myasthenia Gravis Activities of Daily Living (MG-ADL), Quantitative Myasthenia Gravis (QMG), Myasthenia Gravis Composite (MGC), and MG Quality of Life 15-item scale (MG-QoL15)—were assessed at each visit.
Results:
Mean score changes from baseline to 15 months were QMG (−5.6), MG-ADL (−4.0), MGC (−6.4), and MG-QoL15 (−5.8). All patients achieved a prednisone dose of ≤5 mg/day by month 15. Serum IgM levels declined below the lower limit of normal in all patients, IgG levels were subnormal in two patients, and IgA levels remained stable. Reported adverse events included pneumonia and herpes zoster.
Conclusions:
Long-term B cell depletion with inebilizumab demonstrated sustained efficacy in reducing disease activity for generalized MG with controllable immune function impacts，making it a favorable option for gMG patients.
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