Universal STAR-T Cell Injection in Generalized Myasthenia Gravis

Inclusion criteria

• Subjects must meet all the following inclusion criteria to be enrolled in this study:

• Age 18-65 years (inclusive), gender (no gender restriction);
• Previously diagnosed with Generalized Myasthenia Gravis (GMG), meeting the 2020 MGFA diagnostic criteria, with MG-ADL total score ≥6 and ocular-related subscore <50% of the total score, positive relevant antibodies, MGFA classification Grade II-IV, and having received at least 2 kinds of immunosuppressants or biological agents for standardized treatment;
• Have received MG treatment for at least 3 months and present with any of the following conditions:

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• MG-ADL total score increased by ≥2 points, and no single ocular item increased by >1 point;
• QMGS total score increased by ≥3 points, or ≥2 non-ocular items each increased by ≥1 point;
• Increased dose of MG-related drugs, hospitalization, or emergency intervention required due to MG exacerbation; 4. Function of important organs meets the following requirements:

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• Bone marrow function:

• Absolute neutrophil count ≥1×10⁹/L (no colony-stimulating factor treatment within 2 weeks before testing);
• Hemoglobin ≥80 g/L (excluding neutropenia caused by disease);
• Liver function: ALT ≤3×ULN (elevated ALT due to disease is excluded); AST ≤3×ULN (elevated AST due to disease is excluded); TBIL ≤1.5×ULN (elevated TBIL due to disease is excluded);
• Renal function: Serum creatinine (CrCl) ≥45 mL/min (calculated by Cockcroft-Gault formula; acute CrCl decrease due to disease is excluded);
• Coagulation function: International Normalized Ratio (INR) ≤1.5×ULN; Prothrombin Time (PT) ≤1.5×ULN;
• Cardiac function: Systolic blood pressure >90 mmHg, no need for vasoactive drug maintenance; 5. Female subjects of childbearing potential and their male partners (of childbearing age) must use medically recognized contraceptive measures or abstain from sex during the study treatment period and for at least 12 months after the end of study treatment; female subjects of childbearing age must have a negative serum HCG test within 7 days before enrollment and not be in lactation; 6. Voluntarily participate in this clinical study, sign the informed consent form, be compliant, and cooperate with follow-up.

Exclusion criteria

• Subjects who meet any of the following exclusion criteria will be excluded from this study:

• Have used immunomodulatory or immunosuppressive drugs with therapeutic effects on the disease within 5 half-lives before enrollment, or biologics within 4 weeks (except for those who have received rituximab, with the last use of rituximab <3 months prior [B-cell reconstitution is excluded]);
• Have a history of severe drug allergy or allergic constitution;
• Have uncontrolled or requiring treatment for fungal, bacterial, or viral infections;
• Have active tumor lesions at screening;
• Have cardiac insufficiency (New York Heart Association [NYHA] functional class >II), and cannot tolerate platelet and cellular transfusions;
• Have congenital immunodeficiency;
• Have a history of malignant tumor (except for cured cutaneous basal cell carcinoma or cervical carcinoma in situ);
• Have end-stage renal failure;
• Positive for Hepatitis B surface Antigen (HBsAg), or positive for Hepatitis B core antibody (HBcAb) with peripheral blood HBV DNA level or titer above the cutoff value for positive specimens; positive for Hepatitis C virus (HCV) antibody with peripheral blood HCV RNA positive; positive for Human Immunodeficiency Virus (HIV) antibody; positive for syphilis testing;
• Pregnant or planning to become pregnant during the study or within 2 years after the end of study treatment (for both male and female subjects);
• Investigators consider there are other reasons that should not be included in this study.