Which medications in the drug class Monoclonal Antibodies are used in the treatment of Myasthenia Gravis?

Updated: Aug 27, 2018
  • Author: Abbas Jowkar, MD; Chief Editor: Nicholas Lorenzo, MD, MHA, CPE  more...
  • Print
Answer

Monoclonal Antibodies

Monoclonal antibodies are used to bind to one specific substance in the body (eg, molecules, antigens). This binding is very versatile and can mimic, block, or cause changes to enact precise mechanisms (eg, bridging molecules, replacing or activating enzymes or cofactors, immune system stimulation).

In October 2017, the FDA approved eculizumab for the treatment of generalized myasthenia gravis (gMG) in adults who are anti-acetylcholine receptor (AchR) antibody-positive. Approval was based on data from the phase 3, multicenter, randomized, double-blind, placebo-controlled REGAIN study that randomized 62 patients to eculizumab and 63 to placebo. Patients were randomly assigned (1:1) to either IV eculizumab or IV matched placebo for 26 weeks. The primary efficacy endpoint for gMG was a comparison of the change from baseline between treatment groups in the Myasthenia Gravis-Specific Activities of Daily Living scale (MG-ADL) total score at week 26. Treatment with eculizumab showed a statistically significant difference in the mean change from baseline to week 26 in MG-ADL total scores (–4.2 points vs. –2.3 points). [60]

Rituximab (Rituxan)

Rituximab is a genetically engineered chimeric murine-human monoclonal antibody (mAb) directed against the CD20 antigen found on the surfaces of normal and malignant B cells. The antibody is an IgG1κ immunoglobulin containing murine light- and heavy-chain variable region sequences and human constant region sequences. Risk of progressive multifocal leukoencephalopathy associated with use.

Eculizumab (Soliris)

Eculizumab is a complement inhibitor. Its precise mechanism in gMG patients is unknown, but is presumed to involve reduction of terminal complement complex C5b-9 deposition at the neuromuscular junction. It is indicated for the treatment of generalized myasthenia gravis in adults who are anti-acetylcholine receptor (AchR) antibody-positive.


Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!