Usefulness of Early Treatment with Efgartigimod in Patients with Generalized Myasthenia Gravis Complicated by Cardiovascular Disease: A Case Report.

BACKGROUND: Generalized myasthenia gravis (gMG) is an autoimmune disease associated with several autoantibodies that attack neuromuscular junctions. Parenteral fast-acting treatment (FT) using steroid pulses, intravenous immunoglobulin (IVIg) and/or plasmapheresis is beneficial for the initial treatment of gMG. However, some patients with gMG have concomitant cardiovascular diseases, such as cardiac insufficiency and ischemic heart disease, in real-world clinical practice. Thus, conventional FT is sometimes difficult to administer in these patients because of its potential cardiovascular side effects.

CASE PRESENTATION: We report a case of a patient with gMG complicated by cardiovascular disease who was successfully treated with a new therapy using the neonatal Fc receptor inhibitor efgartigimod instead of conventional early FT with steroid pulses, IVIg, and/or plasmapheresis.

CONCLUSION: Efgartigimod may represent a feasible alternative to conventional FT for the management of gMG, particularly in patients with significant cardiovascular comorbidities.