[Pubmed] Complement C5 inhibition in generalized myasthenia gravis is associated with improved survival and increased ca

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Front Immunol. 2026 May 14;17:1812643. doi: 10.3389/fimmu.2026.1812643. eCollection 2026.

ABSTRACT

BACKGROUND: Complement C5 inhibitors are effective disease-modifying therapies for acetylcholine receptor antibody-positive generalized myasthenia gravis (MG), but cardiovascular safety has not been evaluated as a dedicated outcome domain. With increasing and prolonged use, systematic assessment of cardiovascular and thromboembolic risk - including potential differences between individual C5 inhibitors - is needed.

METHODS: We performed a retrospective cohort study using the TriNetX federated electronic health record network, including adults with generalized MG. Propensity score-matched cohorts compared patients treated with C5 inhibitors with untreated controls (N = 1,094 vs. 1,094), and ravulizumab with eculizumab (N = 330 vs. 330). Outcomes included major adverse cardiovascular events (MACE), thrombotic disorders, acute kidney injury (AKI), arrhythmias, and all-cause mortality over 365 days. Associations were evaluated using risk ratios (RR) and Cox proportional hazards models.

RESULTS: After matching, C5 inhibition was associated with increased risk of AKI (6.1% vs 3.2%, p

Source: https://pubmed.ncbi.nlm.nih.gov/4222052 ... 8&v=2.20.0