News|Articles|April 8, 2026

Quality of Life, Symptoms Scores Improved in MG When Using Ravulizumab

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Key Takeaways

Pooled efficacy favored ravulizumab, improving QMG (MD –2.91) and MG-ADL (MD –2.64) after ~25 weeks, despite substantial between-study heterogeneity.
Clinically meaningful MG-ADL response (≥2-point reduction) occurred in 69% of treated patients, exceeding the 53% response rate observed in placebo comparators.
Patient-reported outcomes improved, with MG-QoL15 demonstrating a mean benefit (MD –4.61), supporting functional and quality-of-life gains beyond bedside weakness metrics.
Safety signals were common; 80.52% reported adverse events and ~40% were considered ravulizumab-related, emphasizing the need for contextualized tolerability interpretation.
Generalizability is constrained by variable designs/protocols, limited sample sizes, exclusion of seronegative MG and pregnancy, and outcome assessment restricted to 10–38 weeks.

Both Quantitative Myasthenia Gravis and Myasthenia Gravis Activities of Daily Living scores improved after treatment.

Raviluziumab improved both the Quantitative Myasthenia Gravis (QMG) and Myasthenia Gravis Activities of Daily Living (MG-ADL) scores of patients with generalized myasthenia gravis (gMG) according to a new study published in Immunologic Research.¹ Specifically, patients with autoantibodies that target acetylcholine receptors (AChR-Ab) saw significant benefits.

MG primarily affects muscles in the body, causing weakness and fatigue in those with the diagnosis, 85% of whom have the AChR-Ab form of the condition. gMG is experienced by approximately 80% of those who show initial signs of ocular MG. Immunosuppressants are often first-line therapy for treating gMG, and complement C5 inhibitors like ravulizumab can target the underlying pathophysiology of gMG.²This review aimed to collect evidence on the use of ravulizumab in AChR-Ab gMG when it comes to how it affects QMG and MG-ADL scores as well as the reduction of corticosteroids and safety.¹

Researchers used PubMed, Web of Science, Scopus, and Cochrane CENTRAL to find studies to include in the review. The databases were searched from their inception date through May 3, 2025, with clinical trials, observational studies, and case series all eligible for inclusion. All included studies needed to focus on real-world and research settings that evaluated how effective and safe ravulizumab was in patients diagnosed with AChR-Ab gMG; case reports, reviews, animal studies, in vitro studies, and studies that did not include patients with AChR-Ab gMG or did not investigate ravulizumab were excluded from the review. Data were extracted from all studies for this review, and outcome measures were the QMG and MG-ADL scores.

There were 6 studies included in the final analysis, of which 1 was a randomized controlled trial, 1 was a case series, 1 was a prospective trial, and 3 were retrospective observational studies. There were 321 patients across the studies who had a mean (SD) age of 56.27 (18.78) years. A history of prior thymectomy was found in 60% of the patients.

QMG scores were improved across 4 studies with a mean follow-up of 24.8 weeks (mean difference [MD], –2.91; 95% CI, –4.50 to –1.32). MG-ADL was measured in all 6 studies and showed a significant improvement after a mean follow-up of 25.14 weeks (MD, –2.64; 95% CI, –3.75 to –1.54). Heterogeneity was found in both analyses.

A clinically meaningful improvement rate was found in 69% of the patients, defined as at least a 2-point reduction in the MG-ADL score. This was compared with 53% who reported a clinically meaningful improvement in the placebo group. Ravulizumab was associated with an improvement in quality of life based on the Myasthenia Gravis Quality of Life 15-point scale (MD, –4.61; 95% CI, –8.44 to –0.77). Adverse events were reported in 80.52%, and adverse events related specifically to ravulizumab were reported in 40%.

There were some limitations to this study. The results were limited by the studies included. There was heterogeneity across all of the studies, including in design, patient demographics, protocols, and outcome measurements. There was a small sample size in clinical and observational studies. Patients with seronegative MG and pregnant women were not included in the review. Clinical benefits could be hard to assess due to the focus on the MG-ADL scale. All results were measured within 10 to 38 weeks of administration.

“This systematic review and meta-analysis demonstrates that ravulizumab offers significant clinical benefits for patients with AChR-Ab gMG,” the authors concluded. “Treatment with ravulizumab led to marked improvements in QMG and MG-ADL scores and quality of life in AChR-Ab gMG patients.”

References

Sabet H, Abbas A, AbuHamdia A, et al. Effectiveness and safety of ravulizumab in anti-acetylcholine receptor antibody-postive (AChR-Ab+) generalized myasthenia gravis: a systematic review and meta-analysis. Immunol Res. 2026;74(1):35. doi:10.1007/s12026-026-09770-6
Myasthenia gravis (MG). Cleveland Clinic. Updated November 10, 2023. Accessed April 8, 2026. https://my.clevelandclinic.org/health/diseases/17252-myasthenia-gravis-mg