Efgartigimod (Vyvgart®) and ravulizumab (Ultomiris®) are two new-generation monoclonal antibodies, anti-FcRN and anti-C5 respectively, designed to treat refractory forms of generalised autoimmune myasthenia with positive autoantibodies against the acetylcholine receptor. German clinicians have attempted to compare their efficacy and safety indirectly:
- the results of the two main studies of one (ADAPT trial) and the other (CHAMPION trial) were the subject of a meta-analysis,
- the improvement in the various quality of life or daily activities scores (MG-QoL15r, MG-ADL) at 26 weeks was in favour of efgartigimod,
- efgartigimod provided a faster (with better scores from the first four weeks) and more significant response.
This comparison applies especially to quality of life, a concept that is always debatable because it is largely subjective.