An expert opinion on the (good) results of rozanolixizumab in myasthenia gravis

Three neurologists from Toronto’s Centre for Neuromuscular Diseases have analyzed the findings of various trials of rozanolixizumab (Rystiggo®), a monoclonal antibody directed against neonatal Fc receptors (anti-FcRn), in autoimmune myasthenia with anti-RACh or anti-MuSK antibodies. They conclude that :

  • rozanolixizumab is effective, reducing pathogenic IgG by up to -78%, similar to plasma exchange;
  • it also improves various clinical parameters such as MG-ADL, QMG, MGC and MG-PRO scores (phase III trial);
  • it is well tolerated, with fewer side effects than many other myasthenia treatments, the most frequent being headaches;
  • it is easier and quicker to administer (subcutaneous route) than other anti-FcRn drugs (intravenous route), and an open-label self-administration trial is currently underway.

For the Canadian experts, these good results have yet to be confirmed in real life, since rozanolixizumab already has marketing authorization in the US (June 2023) and Europe (January 2024).

 

An evaluation of rozanolixizumab-noli for the treatment of anti-AChR and anti-MuSK antibody-positive generalized myasthenia gravis. Matic A, Alfaidi N, Bril V. Expert Opin Biol Ther. 2023 Jul-Dec;23(12):1163-1171.