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Non-Cyclic Rozanolixizumab Administration in Complex Generalized Myasthenia Gravis.
Marc Abi Aoun1, Diane Beauvais2, Marlène Barnay2
1Neurology Department, Robert Boulin Hospital, Libourne, France.
Muscle & Nerve
|May 20, 2026
Summary
Fortnightly administration of rozanolixizumab improved generalized myasthenia gravis (gMG) symptoms and reduced hospitalizations in complex gMG patients. This non-cyclic regimen may prevent disease fluctuations associated with standard intermittent dosing.
Area of Science:
- Neurology
- Immunology
- Pharmacology
Background:
- Generalized myasthenia gravis (gMG) is an autoimmune disorder affecting neuromuscular junctions.
- Rozanolixizumab, a neonatal Fc receptor (FcRn) inhibitor, treats refractory gMG.
- The standard cyclic regimen may cause disease fluctuations and a "wearing-off" effect.
Purpose of the Study:
- To evaluate the efficacy and safety of non-cyclic (fortnightly) rozanolixizumab administration.
- To assess its impact on complex gMG patients refractory to standard treatments.
- To investigate potential prevention of cyclical relapses.
Main Methods:
- Retrospective study of eight anti-acetylcholine receptor antibody-positive complex gMG patients.
- Patients transitioned to weekly or fortnightly rozanolixizumab after relapse.
- Primary outcome: ≥2-point improvement in Myasthenia Gravis Activities of Daily Living (MG-ADL) score at 3 months; assessed clinical data and serum IgG levels.
Main Results:
- Significant rapid improvement in MG-ADL scores from 10.8 to 4.1 within 3 months.
- Reduced hospitalizations from 15.8 to 0 days/month; enabled corticosteroid tapering.
- Mean serum IgG levels decreased by ~50% and stabilized; favorable safety profile with one discontinuation.
Conclusions:
- Fortnightly rozanolixizumab demonstrated sustained clinical benefits in complex gMG.
- This non-cyclic dosing strategy reduced hospitalizations and steroid dependence.
- Further research is needed to confirm efficacy and long-term safety in larger cohorts.
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