Study ties Rystiggo to fewer hospital stays, less corticosteroid need

People with myasthenia gravis (MG) tend to have fewer hospitalizations and less need for corticosteroids after starting treatment with Rystiggo (rozanolixizumab-noli), according to an analysis of insurance claims data from the U.S.

Corticosteroids are anti-inflammatory medications commonly used in MG, “but long-term use is associated with a number of serious side effects, [so] reducing corticosteroid use is a key goal in MG,” the researchers wrote.

“Reduced use of corticosteroids and lower all-cause and MG-related HCRU [healthcare resource utilization] were observed following [Rystiggo] initiation, indicating treatment benefits and reduced healthcare burden in this patient population,” they wrote.

The study, “Treatment Characteristics and Healthcare Resource Utilization Among Patients with Myasthenia Gravis Initiating Rozanolixizumab: A US Claims Database Analysis,” was published in Neurology and Therapy. The work was funded by UCB, which sells Rystiggo. The findings were also presented in a poster at the American Academy of Neurology’s annual meeting last month.

MG is an autoimmune disorder driven by self-reactive antibodies that block signaling from nerves to muscles, resulting in symptoms such as muscle weakness and fatigue. The disease can be complex to manage, and patients often require multiple types of medication and frequent hospitalizations.

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Real-world analysis

Rystiggo is approved in the U.S. for adults with generalized MG who are positive for antibodies targeting the acetylcholine receptor or muscle-specific tyrosine kinase, the two most common MG-causing antibodies.

The therapy reduces levels of disease-driving antibodies by blocking the activity of a protein that prevents circulating antibodies from being destroyed. It is administered via an under-the-skin infusion pump, once per week in six-week cycles, with additional cycles given as needed to manage symptoms.

Although Rystiggo has been proven effective for easing MG symptoms in clinical trials, “evidence on the use of [Rystiggo] outside of clinical trials has not yet been reported, and it would be beneficial to understand how [Rystiggo] is utilized in the real-world setting, as well as its impact on the use of other MG treatments and on healthcare resource utilization,” the researchers wrote.

The team, led by scientists at UCB, conducted an in-depth analysis of data from a large U.S. insurance claims database. Data from 719 people with an MG diagnosis who started Rystiggo from 2023 to 2025 were included in the analysis. All had at least one year’s worth of data available from before they had started taking the medication.

A little more than half of the patients were women (51.9%) and were enrolled in Medicare (52%). Nearly two-thirds (61.3%) were older than 60, and based on Rystiggo dosages used during follow-up, nearly a third (31.7%) weighed at least 100 kg (about 220 lbs).

Because MG clinical trials generally include younger patients and exclude those with obesity, this real-world analysis may capture a broader spectrum of MG patients than clinical trials, the researchers noted.

Available data showed that patients underwent a mean of about three Rystiggo treatment cycles in the first year, which was lower than the mean of about four cycles reported in late-stage Rystiggo clinical trials. These data suggest “that the typical treatment pattern in clinical practice can be adjusted to individual patient needs,” the team wrote.

Data also indicated that patients tended to use slightly fewer MG-related healthcare resources after starting Rystiggo. The average MG-related HCRU dropped from 88 events per 100 patient-years in the year before Rystiggo initiation to 82.9 per 100 patient-years in the following year. One patient-year is the equivalent of one patient treated for one year.

Consistent decreases were seen across all types of healthcare use, including outpatient visits, hospitalizations, and emergency department visits.

More than half of the patients (53.7%) were taking corticosteroids at the time of Rystiggo initiation and had at least three months of follow-up data available. The majority of these patients saw a reduced need for corticosteroids after starting Rystiggo: 29% decreased their daily corticosteroid dose by at least 5 mg, and another 29.3% discontinued corticosteroids entirely.

The researchers noted that reductions in HCRU and corticosteroid use were also seen in the 26 patients who were on Vyvgart (efgartigimod alfa-fcab) before starting Rystiggo. Vyvgart is another approved MG therapy that works via a similar mechanism to Rystiggo.

The scientists stressed that this subgroup analysis was limited to a small number of patients and that it relied entirely on insurance data, which doesn’t include many important clinical details. Still, they said the data suggest “that if a patient is not satisfied with [Vyvgart] treatment, switching to [Rystiggo] could be a viable option.”

“These data provide the first insights into the real-world use of [Rystiggo] in patients with MG,” the team concluded.