Intravenous Human IgG1 Fc Fragment (Efgartigimod) in Myasthenic Crisis

Study Rationale: The study rationale for investigating the effectiveness of IV efgartigimod in myasthenic crisis hinges on the need for treatments that can provide rapid and targeted relief from the acute exacerbations of MG, which are life-threatening. Current treatments, while potentially effective, can be associated with significant side effects and may not work swiftly enough to address the urgent needs of a myasthenic crisis. Efgartigimod, an FcRn antagonist, has been designed to reduce the circulating levels of pathogenic IgG autoantibodies, which are implicated in the pathophysiology of MG. By accelerating the degradation of these autoantibodies, efgartigimod could potentially offer a faster onset of action and improve clinical outcomes in patients during a myasthenic crisis

Inclusion criteria

• -Age > 18
• MG diagnosis
• A confirmed diagnosis of Myasthenia Gravis (MG) with generalized muscle weakness, classified as MGFA class II, III, IVa, or IVb and V.
• Positive AchR or MuSK antibodies (max three patients of the total cohort) this will be tested in our center for all patients.
• Myasthenic crisis: Worsening of > 3 or an increase >1 MG-ADL points of a sub score of any individual MG-ADL item other than double vision or eyelid droop and its clinically significant by the investigator. Alternatively, weakness related to MG that is severe enough to necessitate intubation or delay Ex-tubation following surgery.
• Willingness to provide informed consent.

Exclusion criteria

-Contraindications to Efgartigimod.

• Other significant medical conditions that may interfere with study participation.
• Prior exposure to Efgartigimod.
• Male patients who do not intend to use effective contraception during trail or within last dosing
• Pateints with worsening muscle weekness due to concurrent infection or medications known to exacerbate MG.
• Patients with known or active seropositive HBV,HCV, HIV.
• Patients with documented lack of clinical response to Flax.
• Use of any investigational drug within 3 month or 5 helf -lives prior to screening.
• Avidance of significant disease ,recent major surgery or renal/ hepatic function who can put patient at undue risk.
• Previous participation in clinic trail involving ARGX-113
• Vaccination recived whitin 4 weeks prior screening using live or attenuated vaccinations.
• Patient Calssified MGFA Class 1

• Pregnant and lactating women