There are 8 approved therapies now available to the generalized myasthenia gravis (gMG) community. The Sumaira Foundation is pleased to share the first-of-its-kind, gMG Therapies Chart.
Our goal in laying out these new and available therapies side-by-side is to empower the patient community to discuss their treatment options with their doctors to make informed decisions about their best paths forward. At TSF, we’re strong advocates for shared decision-making between patients and their physicians, especially when it comes to deciding what long-term treatment(s) to opt for.
This chart has been created by TSF. Our Foundation works with therapy makers equally with an unbiased and objective lens.
Special thanks to Dr. Raffaele Iorio (subject-matter expert) and Tia Chakrapani for their efforts in bringing this chart to fruition.
Legend:
– Definition in text and audio format
 Uplizna® (inebilizumab-cdon) |  Imaavy® (nipocalimab-noli) |  Zilbrysq® (zilucoplan) |  Rystiggo® (rozanolixizumab-ulkh) |  Vyvgart® (efgartigimod alfa + hyaluronidase-qvfc) |  ULTOMIRIS® (ravulizumab-cwvz) |  Vyvgart® (efgartigimod alfa-fcab) |  Soliris® (eculizumab) | Mestinon® (pyridostigmine bromide) | |
| Pharmacology | Anti-CD19 B cell depleting monoclonal antibody | FcRn blocker (monoclonal antibody) | Complement C5 inhibitor (macrocylic peptide) | FcRn blocker (monoclonal antibody) | FcRn blocker (Human IgG1 Fc fragment) | Complement C5 inhibitor (long-acting monoclonal antibody) | FcRn blocker (Human IgG1 Fc fragment) | Complement C5 inhibitor (monoclonal antibody) | Acetylcholinesterase inhibitor (symptomatic therapy) |
| Drug Delivery Method | IV infusion (90 min) | IV infusion (initial ≥30 min; maintenance ≥15 min) | Subcutaneous self-injection (prefilled syringe) | Subcutaneous infusion (administered by HCP) | Subcutaneous injection (~30 sec prefilled syringe; self-administered or by caregiver) | IV infusion (>= 30 min, weight based) | IV infusion (~1 hr) | IV infusion (35 min) | Oral (tablets, extended-release tablets, oral solution) |
| Administration Setting | Infusion center / outpatient clinic | Infusion center / outpatient clinic | Self-administered | Infusion center / outpatient clinic | Self-administered / caregiver-administered | Infusion center / outpatient clinic | Infusion center / outpatient clinic | Infusion center / outpatient clinic | Self-administered |
| Frequency | Every 6 months, after 2 initial doses 2 weeks apart | Every 2 weeks (continuous), after initial loading dose | One daily (continuous) | Cycles of once weekly x 6 weeks; subsequent cycles based on clinical evaluation (>=63 days between cycle starts) | Cycles of once weekly × 4 weeks; subsequent cycles based on clinical evaluation | Every 8 weeks, starting 2 weeks after loading dose | Cycles of once weekly × 4 weeks; subsequent cycles based on clinical evaluation | Every 2 weeks, after 4 weekly induction doses + 5th dose at week 5 | Multiple times daily, adjusted to symptoms; extended-release: once or twice daily (≥6 hrs apart) |
| Dosage | 300 mg IV per infusion | Loading: 30 mg/kg once; Maintenance: 15 mg/kg every 2 weeks | Weight-based: 56 kg: 16.6 mg; 56-77 kg: 23 mg; >77 kg: 32.4 mg daily | Weight-based: 50 kg: 420 mg; 50-100 kg: 560 mg; >=100 kg: 840 mg | 1008 mg per prefilled syringe | Loading: 2400-3000 mg (weight-based); Maintanence: 3000-3600 mg every 8 weeks | 10 mg/kg IV (max 1200 mg) per infusion | Induction: 900 mg weekly x 4 weeks; maintenance: 1200 mg every 2 weeks | Immediate-release: 60 mg tablets, average 600 mg/day (range 60–1500 mg); Extended-release: 180 mg tablets, 1–3 tablets once or twice daily |
| Antibody Criteria | AChR Ab+ or MuSK Ab+ gMG | AChR Ab+ or MuSK Ab+ gMG (adults and pediatric ≥12 yrs) | AChR Ab+ gMG | AChR Ab+ or MuSK Ab+ gMg | AChR Ab+ gMG | AChR Ab+ gMG | AChR Ab+ gMG | AChR Ab+ gMG | All MG subtypes (AChR Ab+, MuSK Ab+, seronegative) |
| Available for Pediatric Patients | No | 12 years and older | No | No | No | No | No | 6 years and older | Widely used off label for jMG |
| Common Side Effects | Headache, infusion-related reactions, nasopharyngitis, urinary tract infection, cough | Infections, headache, peripheral edema, muscle spasms | Injection site reactions, upper respiratory, infection, diarrhea | Headache, diarrhea, pyrexia | Injection site reactions, headache, respiratory tract infections | Headache, upper respiratory infection, diarrhea | Headache, respiratory tract infections, urinary tract infection | Headache, upper respiratory infection, nasopharyngitis | Diarrhea, abdominal cramps, nausea, increased salivation, increased sweating, urinary urgency, flatulence |
| Potential Serious Side Effects | Infections (including opportunistic); infusion reactions; reduction in immunoglobulins | Infections, headache, peripheral edema, muscle spasms | Menigococcal infections; pancreatitis (monitor lipase/ amylase) | Infections; reduced IgG levels; headache (severe) | Infections; reduced IgG levels; injection site reactions | Meningcoccal infections; infusion reactions | Infections; reduced IgG levels | Meningococcal infections; infusion reactions | Cholinergic crisis (muscle weakness, respiratory failure from overdose); bronchospasm |
| Manufacturer |  |  |  | |  |  | | | Multiple generic manufacturers (formerly ICN/Valeant as Mestinon®) |
| Year of FDA Approval | December 2025 | April 2025 | October 2023 | June 2023 | June 2023 | April 2022 | December 2021 | October 2017 | 1955 |
| Assistance Programs | Amgen By Your Side | J&J withMe | UCB | UCB | Argenx | Alexion OneSourceTM | Argenx | Alexion OneSourceTM | Generic; widely avalible at low cost |
| Prescribing Information | Uplizna® (inebilizumab-cdon) Prescribing Information | Imaavy® (nipocalimab-noli) Prescribing Information | Zilbrysq (zilucoplan) Prescribing Information | Rystiggo® (rozanolixizumab-ulkh) Prescribing Information | Vyvgart Hytrulo® (efgartigimod alfa + hyaluronidase-qvfc) Prescribing Information | Ultomiris (ravulizumab-cwvz) Prescribing Information | VYVGART prescribing information | Argenx | Soliris (eculizumab) Prescribing Information | Mestinon® (pyridostigmine bromide) Prescribing Information |
This patient education resource was made possible with support from argenx and Johnson & Johnson