Efficacy and Safety of Double‐Filtration Plasmapheresis Versus Efgartigimod in Generalized Myasthenia Gravis: A Single‐Center Retrospective Study

Myasthenia gravis (MG) is an autoimmune neuromuscular disorder characterized by fluctuating muscle weakness. Double-filtration plasmapheresis (DFPP) and efgartigimod are commonly used therapeutic strategies for patients with generalized MG (gMG). This single-center retrospective study aimed to evaluate and compare the efficacy and safety of DFPP and efgartigimod in the management of gMG. We retrospectively reviewed clinical records of gMG patients who received either DFPP or efgartigimod at our hospital. This was not a crossover study, and no patient received both treatments during the study period. Collected data included demographic and clinical characteristics, antibody titers, Myasthenia Gravis Activities of Daily Living (MG-ADL) scores, Quantitative Myasthenia Gravis (QMG) scores, and treatment-related adverse events. Immunoglobulin and antibody levels before and after therapy were analyzed to assess treatment responses. A total of 31 patients with gMG were included, comprising 17 who underwent DFPP and 14 who received efgartigimod. The participants ranged from 25 to 79 years of age, and 74.2% were female. Anti-acetylcholine receptor antibodies were detected in 25 patients. Both DFPP and efgartigimod significantly reduced immunoglobulin and pathogenic antibody levels and improved MG-ADL and QMG scores. Between-group differences in the observed short-term changes were not statistically significant. Mild adverse events, including catheter-site bleeding and transient limb weakness, occurred in the DFPP group, whereas no adverse events were reported among efgartigimod-treated patients. Both DFPP and efgartigimod effectively reduced antibody levels and improved clinical symptoms in patients with gMG after a single treatment course. Efgartigimod showed favorable tolerability in this cohort, although this finding should be interpreted cautiously given the small sample size and retrospective design.