case_images: PMC11825329_01
case_images: Medical history of the four refractory gMG patients. gMG, generalized myasthenia gravis; IVIG, intravenous immunoglobulin.
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case_images: fig1
case_images: The clinical characteristics and medical history of these four individuals are comprehensively summarized in Table 1 and Figure 1.
case_images: Clinical scale changes following telitacicept treatment from basline to week 12. (A) Change from baseline to week 12 in MGFA-QMG. (B) Change from baseline to week 12 in MGQOL-15. (C) Change from baseline to week 12 in MG-ADL. MGFA-QMG, Myasthenia Gravis Foundation of America Quantitative Myasthenia Gravis Score; MGQOL-15, 15-item Myasthenia Gravis Quality of Life Scale; MG-ADL, MG-associated Activities of Daily Living score.
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case_images: PMC11825329_01_fneur-16-1501500-g002.jpg
case_images: fig2
case_images: Notably, this enhanced clinical state was sustained, as demonstrated by the stable scores observed in these patients (Figure 2). Interestingly, during the one-month follow-up period post-telitacicept withdrawal, their gMG clinical scores remained unchanged, suggesting a sustained therapeutic effect of the drug (Figure 2).
case_images: Change in CD19+ B cells and antibody levels over the 12-week study period. (A) Changes in CD19+ B-cell counts over the study period. (B) Changes in IgA levels over the study period. (C) Changes in IgG levels over the study period. (D) Changes in IgG levels over the study period. (E) Changes in AChR levels over the study period. AChR, acetylcholine receptor; IgA, immunoglobulin A; IgG, immunoglobulin G; IgM, immunoglobulin M.
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case_images: PMC11825329_01_fneur-16-1501500-g003.jpg
case_images: fig3
case_images: This trend of declining CD19+B cell counts was consistent throughout the treatment duration, up to week 8 (Figure 3A). This pattern is indicative of the immunomodulatory effect of telitacicept (Figures 3B-D). Consistent with the therapeutic goal, there was an overall downward trajectory in AChR antibody levels throughout the treatment period, further supporting the clinical effectiveness of telitacicept in these patients (Figure 3E).