Early Myasthenia Gravis Activities of Daily Living (MG-ADL) Response to Ravulizumab in Acetylcholine Receptor-Positive Generalized Myasthenia Gravis Refractory: A Case Report From Latin America

TL;DR

A patient with severe myasthenia gravis showed rapid improvement after treatment with ravulizumab, a new therapy that inhibits a part of the immune system.

Contribution

This is the first reported case of ravulizumab use in Chile for AChR-positive MG refractory to rituximab.

Findings

The patient's MG-ADL score improved significantly within two weeks of starting ravulizumab.

Ravulizumab was effective in a patient who had multiple myasthenic crises and failed conventional treatments.

The case suggests ravulizumab could be a novel therapeutic option for refractory generalized MG.

Abstract

This case report details the first use of ravulizumab in Chile for a patient with acetylcholine receptor (AChR)-positive myasthenia gravis (MG) who did not respond to rituximab (RTX). A 26-year-old female presented with progressive MG symptoms, including fatigue and bilateral ptosis. Despite conventional treatment and thymectomy, she experienced multiple myasthenic crises. Following the lack of response to RTX, ravulizumab was initiated, resulting in a significant improvement in the Myasthenia Gravis Activities of Daily Living (MG-ADL) score in less than two weeks. Ravulizumab, a monoclonal antibody that inhibits complement component C5, was approved for MG in 2022 and is being assessed for efficacy in neurological disorders. This report highlights its potential as a therapy for MG in the absence of robust local evidence, offering a novel therapeutic option for managing this debilitating condition.

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