Legacy and Innovation: Pivotal Role of Complement in gMG and AQP4-Ab+ NMOSD – A Video Series

Achieving Valuable Outcomes in Generalised Myasthenia Gravis: Evolution of Evidence and Experience with Ravulizumab

Watch Andreas Meisel and Heinz Wiendl share updates from recent clinical guidelines and review current ravulizumab data in patients with generalised myasthenia gravis (gMG) in this Alexion-sponsored satellite session at the 10^th Congress of the European Academy of Neurology (EAN), held on the 30^th of June 2024 in Helsinki, Finland.

Part 1 – Innovative Treatment Options in Generalised Myasthenia Gravis: Implementation of Recent Guidelines
In the first portion of this satellite session, Meisel discusses key updates to the German Neurological Society’s ‘Guideline for the Management of Myasthenic Syndromes’ and ‘The Japanese Clinical Guidelines 2022 for Myasthenia Gravis and Lambert-Eaton Syndrome’.

Part 2 – Clinical Insights from Real-world Evidence: Novel Therapies in Generalised Myasthenia Gravis
In the second portion of this satellite session, Wiendl reviews the recent ravulizumab clinical trial data and real-world evidence highlighting the sustained clinical effectiveness and long-term safety of ravulizumab.

1. Chief Executive Director, Center for Stroke Research Berlin (CSB); NeuroCure Clinical Research Center (NCRC); Head of Research Group A. Meisel; Professor of Neurology & Neurointensivist, Deptartment of Neurology with Experimental Neurology and NeuroCure Clinical Research Center; Chariman, Berlin Stroke Alliance; Professor, Integrated Myasthenia Gravis Center, Charité Universitätsmedizin, Berlin, Germany; and Chairman, Medical Advisory Board of the German Myasthenia Society.

2. Director, Neurology University Hospital Münster, Germany; Speaker, Collaborative Research Center 128 “Multiple Sclerosis”; Speaker, The Competence Network Multiple Sclerosis (KKNMS); Founder & Principal Investigator, The Body and Brain Institute Münster (BBIM), Germany; and Member, Steering Committee, Champion MG.

Complement as a Therapeutic Target: Clinical Experience and Real-world Evidence

Watch Orhan Aktas review the role of the complement system in the pathophysiology of anti-aquaporin-4 antibody-positive (AQP4-Ab+) neuromyelitis optica spectrum disorder (NMOSD), Jin Nakahara explore efficacy and safety highlights from clinical experience and real-world evidence with complement component 5 inhibitor therapy (C5IT), Austin Kulasekararaj provide insights into considerations for initiating C5ITs in non-neurological indications, and our panel of faculty members share best practices in treating patients with C5ITs for AQP4-Ab+ NMOSD in this symposium at the 10^th Congress of the EAN, held on the 30^th of June 2024 in Helsinki, Finland.

Part 1 – Targeting Complement in AQP4-Ab+ NMOSD
In the first part of the symposium, Aktas highlighted the significance of complement-mediated astrocyte destruction in driving NMOSD and identified C5 as a crucial target for treating this rare disease.

Part 2 – Efficacy and Safety of Ravulizumab and Eculizumab in Patients with AQP4-Ab+ NMOSD
In the second part of the satellite session, Nakahara provided a review of recent ravulizumab clinical trial data and eculizumab real-world evidence, emphasising the clinical effectiveness and long-term safety of C5IT therapy in AQP4-Ab+ NMOSD.

Part 3 – Considerations from Non-neurological Indications for Initiating C5ITs
In the third part of the satellite session, Kulasekararaj, a haematology expert, discussed non-neurological indications such as paroxysmal nocturnal haemoglobinuria and the role of complement in this disease. Additionally, he addressed the risk of meningococcal infection with complement inhibitors and shared effective strategies to mitigate this risk based on 20 years of clinical and real-world experience.

3. Department of Neurology – Molecular and Translation Neurology, Heinrich-Heine-University, Düsseldorf; Chair, Düsseldorf Multiple Sclerosis Center, Department of Neurology, Heinrich-Heine University Düsseldorf, Germany; Member, The Sumaira Foundation‘s International Medical Advisory Board; Member, International MS Visual System Consortium (IMSVISUAL); Member, the International Clinical Consortium of The Guthy-Jackson Charitable Foundation for NMOSD Research; and Co-Founder and Co-Coordinator, the German Neuromyelitis Optica Study Group (NEMOS).

4. Professor & Director, Department of Neurology, Keio University School of Medicine, Tokyo; Director, Keio University Parkinson’s Disease Research Centre, Tokyo, Japan; Director, Keio University Hospital Stroke Centre and visiting Professor of the Kanazawa University Graduate School of Medical Sciences, Japan; Director, Japanese Society of Neuroimmunology; Director, Japanese Society of Microcirculation; Director, Japan Multiple Sclerosis Network; Central Organising Committee Member, Pan-Asian Congress for Treatment and Research in Multiple Sclerosis (PACTRIMS); and Member, American Academy of Neurology (AAN) and European Academy of Neurology (EAN).

5. Consultant Haematologist, King’s College Hospital, London; and Head, King’s PNH Centre, Department of Haematology, King’s College Hospital, London, UK.

Experience from the Clinic: What Matters Most to Patients Living with Generalised Myasthenia Gravis?

Watch John Vissing and Sven Meuth share their clinical experience and review aspects of disease management that matter most to patients living with gMG in this Alexion-sponsored satellite session at the 10^th Congress of the EAN, held on the 1^st of July 2024 in Helsinki, Finland.

Part 1 – Prioritising Clinical Care for Patients with Generalised Myasthenia Gravis
In the first section of this satellite session, Vissing discusses the burden of gMG on patients’ lives and emphasises the potential for disparity in treatment expectations between patients and physicians, which should drive improved communication efforts. He highlights the role of complement inhibitors together with new tools and updated practice guidelines in helping patients optimally manage their disease.

Part 2 – A Patient-centric Approach to Generalised Myasthenia Gravis Treatment
In the second section of this satellite session, Meuth acknowledges the many obstacles facing patients living with gMG as they navigate diagnosis and treatment. He recommends that clinical decision-making should always incorporate patient perspectives. Additionally, he reviews two patient cases providing key practical insights in the treatment of gMG with complement inhibitors.

6. Professor of Neurology, University of Copenhagen; Founder & Director, Copenhagen Neuromuscular Center at the National Hospital, Rigshospitalet, Copenhagen, Denmark; and Executive Board Member & Chairman of Program Committee, World Muscle Society (WMS).

7. Professor, Department of Neurology, Institute of Translational Neurology & Neurology Clinic, University of Münster, Germany

Complement in Focus: Clinical and Real-world Evidence for the Prevention of Relapses in AQP4-Ab+ NMOSD

Watch Jérôme de Sèze, Sean Pittock, and Noriko Isobe review the role of the complement system and the pathophysiology of NMOSD, particularly in patients who are AQP4-Ab+. The focus of the discussion included C5ITs, such as eculizumab and ravulizumab, with the emphasis on treating AQP4-Ab+ NMOSD. The overall satellite session is structured to offer insights into the mechanisms by which these treatments work, their clinical efficacy, and real-world applications.

 Part 1 – The Critical Role of Complement and Preventing Relapses as a Key Therapeutic Aim in AQP4-Ab+ NMOSD
In the first part of the satellite session, Pittock delved into the critical role of the complement system in driving the pathophysiology of AQP4+ NMOSD and highlighted C5ITs, like eculizumab and ravulizumab, in preventing relapses. He also reviewed real-world pharmacovigilance data and clinical trial evidence for C5ITs in NMOSD, gMG, and non-neurological indications.

Part 2 – Real-world Experience of C5 Inhibitor Therapy in Adult Patients with AQP4-Ab+ NMOSD
In the second section of the satellite session, Isobe discussed the Japan post-marketing surveillance study on eculizumab, showcasing long-term safety and effectiveness in real-life conditions.

Part 3 – Long-term Outcomes of Ravulizumab Treatment in Adult Patients with AQP4-Ab+ NMOSD
In the final section of the satellite session, Pittock discussed the long-term outcomes of ravulizumab treatment in patients with AQP4-Ab+ NMOSD. He presented the interim results from the CHAMPION-NMOSD study, which evaluates the efficacy and safety of ravulizumab over an extended period.

8. Head of Department, Neuroimmunological Department, Strasbourg University Hospital​, France; and President, French Multiple Sclerosis Project.

9. Professor of Neurology, Mayo Clinic College of Medicine; and Director of Mayo Clinic’s Center for Multiple Sclerosis and Autoimmune Neurology, Rochester, Minnesota, USA.

10. Professor and Chairperson, Department of Neurology, Kyushu University, Fukuoka, Japan.

Job code: M/GL/SOL-g/0004
Date of Prep: Feb 2025

Prescribing information for eculizumab: Eculizumab EU Summary of Product Characteristics

Prescribing information for ravulizumab: Ravulizumab EU Summary of Product Characteristics

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US Prescribing Infromation for Ravulizumab can be found here.

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