Subcutaneous Immunoglobulin Well-Tolerated and Effective in Mild to Moderate Exacerbations of Myasthenia Gravis

Canadian investigators at the University of Alberta evaluated the use of self-administered subcutaneous immune globulin (SCIG) in a prospective, open-label, Phase III crossover trial in adult patients with myasthenia gravis (MG) experiencing mild to moderate worsening of symptoms. Patients self-infused 2 g/kg of SCIG over a period of four weeks. The primary endpoint was change in quantitative MG (QMG) score from baseline to study end at six weeks. Secondary endpoints, including change in manual muscle testing (MMT), MG activities of daily living (MG-ADL) and MG composite (MGC) scores, as well as occurrence of adverse events and tolerability, were assessed.

Twenty-two of 23 patients completed the study. The QMG score decreased from 14.9 ± 4.1 to 9.8 ± 5.6, the MMT score decreased from 16.8 ± 0.5 to 5.2 ± 4.5, the MG-ADL score decreased from 9.5 ± 3.0 to 4.6 ± 3.0, and the MGC score decreased from 17.4 ± 5.0 TO 5.6 ± 4.5 (all results P<0.0001). Common adverse events included headache and injection site reactions. No serious adverse events occurred during the study.