
Zilucoplan’s Edge in Complement Inhibition in Myasthenia Gravis: Miriam Freimer, MD
Miriam Freimer, MD
Mirima Freimer, MD, delves into potential reasons behind the longer-term efficacy of zilucoplan and also speaks to the treatment’s safety profile.
Continuing a recent interview with Miriam Freimer, MD, clinical professor of neurology at The Ohio State University Wexner Medical Center, here she delves more into the reasons behind the longer-term efficacy of zilucoplan, which was
Freimer was an author on 5 abstracts presented at the recent 15th MGFA International Conference on Myasthenia and Related Disorders, held in Den Haag, The Netherlands.
This transcript was lightly edited for clarity; captions were auto-generated.
Transcript
How does zilucoplan compare with other complement C5 inhibitors?
All of these medications have similar efficacy. You have 2 questions there. What happens to somebody at 2 years out? At least in zilucoplan, there's good data to show that people maintain that benefit for at least that 2-year period. There have been some case reports of some patients who've been on eculizumab who stopped responding to it, and it's not entirely clear why that is. One thought is, in the case of eculizumab, that maybe patients are developing their own antibodies to that medication and it's less efficacious—but those things are not clear yet. The number of patients who've had a loss of response 6 years out is still pretty small with those drugs. I'm not sure there's a difference in long-term efficacy in any of these drugs.
The [second] question is, why is there such a rapid response to zilucoplan? It is a little faster than the other drugs that have been studied in the last few years, both the complement class and
What were some of the most common adverse effects, and did these differ between patients who were initiating vs switching treatment?
If you look at the 2 studies of the switch and the initiation, there basically were no differences. The common adverse events, which are pretty typical for most drug studies, were a little bit of headache, or a little bit of nausea, or a little bit of stomach pain. This is a drug that's administered subcutaneously, often into the fat tissue in the abdomen, and patients would occasionally bruise from that, or there's a little discomfort associated with it. Those are also included in the adverse events.
There have been some reports of elevation in lipase, and that was felt to be nonsignificant, and [for] most of those patients, their lipases returned to baseline. There have been a few cases of patients with something called
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