Evaluating inebilizumab in the treatment of generalized myasthenia gravis

Myasthenia gravis (MG) is the most common neuromuscular junction disorder. Despite the recent advances in the field, there are still unmet needs. Novel treatments based on new mechanisms of action are now available, including complement inhibitors, neonatal FcRn inhibitors and more recently, B cell-targeted therapies. This review provides a comprehensive overview of inebilizumab, emphasizing its clinical efficacy, safety profile, and potential role in managing MG. Inebilizumab targets CD19 B cells, thereby extending beyond conventional CD20-targeted therapies. Recent results from MINT study suggests that inebilizumab may provide meaningful and sustained disease control, with a potentially favorable safety profile. However, long-term data remains uncertain. Head-to-head comparisons with other B cell therapies, complement inhibitors or FcRn inhibitors are lacking. Patient selection will be critical, with inebilizumab best suited for refractory MG or those who have not responded adequately to existing biologics. As the treatment options for MG expands, choosing the right treatment for the patient will rely on thoroughly evaluating the efficacy, time to achieve minimal symptomatic state, comparative effectiveness, treatment burden, side effects, and cost. Ultimately, data from clinical practice and ongoing phase III trials will be essential to define the best role of inebilizumab in treatment of MG.