Figure 4.

Impact from immunotherapies on refractory MG based on disease exacerbation. (A) MG exacerbation rate per patient-year of rituximab, eculizumab, tacrolimus, and cladribine. (B) MG crisis rate per patient-year of rituximab, eculizumab, tacrolimus, and cladribine. MG exacerbation was defined as MG symptoms with increased frequency and/or intensity. Myasthenic crisis was defined as exacerbated MG symptoms that required intubation or rescue therapy such as plasma exchange and intravenous immunoglobulin. A random-effect model was used for quantitative synthesis. No significant difference in frequency of MG exacerbation or crisis between the rituximab group and eculizumab group was revealed. The studies with Tacrolimus and cladribine were excluded since no disease exacerbation or crisis has been reported.