Immunity, inflammation and disease · 2026
A Novel Sequential Regimen of Efgartigimod and Telitacicept as Fast-Acting Treatment for Impeding Crisis of MuSK-MG.
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Duan Tianjiao, Ouyang Song, Lu Wei, Yin Weifan
Аннотация
BACKGROUND: Myasthenia gravis (MG) is an autoimmune disorder of the neuromuscular junction. The muscle-specific kinase (MuSK) antibody-positive subtype often involves bulbar and respiratory muscles, conferring a high risk of myasthenic crisis.
METHOD: We report a very late-onset MuSK-MG case complicated by lung infection and acute heart failure, with a history of peptic ulcer. The patient was sequentially treated with efgartigimod and telitacicept, achieving minimal symptom expression (MSE) within 1.5 months.
DISCUSSION: Following the first efgartigimod infusion, QMG and MG-ADL scores improved from 31 to 23 and 22 to 12, respectively. After five injections of telitacicept, symptoms resolved completely on day 47, with scores further reducing to 2 (QMG) and 0 (MG-ADL). Treatment also reduced IgG levels and MuSK-Ab titers, while IgM remained stable.
CONCLUSION: This case demonstrates the successful sequential use of efgartigimod and telitacicept in managing complicated, late-onset MuSK-MG in a state of impeding crisis.
METHOD: We report a very late-onset MuSK-MG case complicated by lung infection and acute heart failure, with a history of peptic ulcer. The patient was sequentially treated with efgartigimod and telitacicept, achieving minimal symptom expression (MSE) within 1.5 months.
DISCUSSION: Following the first efgartigimod infusion, QMG and MG-ADL scores improved from 31 to 23 and 22 to 12, respectively. After five injections of telitacicept, symptoms resolved completely on day 47, with scores further reducing to 2 (QMG) and 0 (MG-ADL). Treatment also reduced IgG levels and MuSK-Ab titers, while IgM remained stable.
CONCLUSION: This case demonstrates the successful sequential use of efgartigimod and telitacicept in managing complicated, late-onset MuSK-MG in a state of impeding crisis.