Does B-Cell Depletion Work in Generalized Myasthenia Gravis?

B cells are critical to autoantibody generation in myasthenia gravis, but previous trials using rituximab yielded conflicting results. Now, researchers are evaluating inebilizumab, a monoclonal antibody targeting CD19 B cells that is currently approved for neuromyelitis optica spectrum disorder.

In this industry-sponsored, international, phase 3 trial, researchers randomized 238 adults with generalized myasthenia gravis (80% acetylcholine receptor [AChR] antibody–positive, 20% muscle-specific kinase antibody–positive) to receive intravenous inebilizumab 300 mg or placebo on days 1 and 15 (and 6 months later in AChR antibody–positive patients). Patients on prednisone underwent a prespecified taper. The primary endpoint was change on the Myast…