Telitacicept as add-on therapy for myasthenic crisis: A retrospective cohort study
Jiamin Peng, Fangyi Shi, Cunzhou Shen, Yan Li, Rong Lai, Hongyan Zhou, Xunsha Sun, Li Feng, Huiyu Feng, Haiyan WangBackground
Myasthenic crisis (MC) is a life-threatening exacerbation of myasthenia gravis (MG) that often requires mechanical ventilation (MV) and intensive care. Following acute stabilization, optimal maintenance immunotherapy remains uncertain in some patients.
Objectives
To evaluate the efficacy and safety of telitacicept as add-on treatment after antibody depletion therapy in patients with MC.
Design
A retrospective, non-randomized, single-center exploratory cohort study.
Methods
We retrospectively reviewed patients with MC treated after antibody depletion therapy at a single center between November 2022 and February 2023. Patients receiving add-on telitacicept plus conventional immunotherapy were compared with patients who received conventional immunotherapy alone. Efficacy was assessed by using changes from baseline in Myasthenia Gravis Activities of Daily Living (MG-ADL) and Quantitative Myasthenia Gravis (QMG) scores, hospitalization-related outcomes, prednisone-equivalent dose, and safety.
Results
Eleven patients were enrolled. At months 1, 3, 6, and 12, median MG-ADL and QMG scores for both groups progressively decreased. No statistically significant differences were observed between groups for either score at any time point (
Conclusion
In this small retrospective exploratory cohort, no statistically significant inter-group differences were observed between telitacicept add-on therapy and conventional immunosuppression across the measured outcomes. Telitacicept may represent a potential strategy for long-term disease control after (MC), but these findings are hypothesis-generating and require confirmation in larger prospective studies.