Safety and efficacy of eculizumab in anti-acetylcholine receptor antibody-positive refractory generalised myasthenia gravis (REGAIN): a phase 3, randomised, double-blind, placebo-controlled, multicentre study

James F Howard; Kimiaki Utsugisawa; Michael Benatar; Hiroyuki Murai; Richard J Barohn; Isabel Illa; Saiju Jacob; John Vissing; Ted M Burns; John T Kissel; Srikanth Muppidi; Richard J Nowak; Fanny O'Brien; Jing-Jing Wang; Renato Mantegazza; Claudio Gabriel Mazia; Miguel Wilken; Carolina Ortea; Juliet Saba; Marcelo Rugiero; Mariela Bettini; Gonzalo Vidal; Alejandra Dalila Garcia; Phillipa Lamont; Wai-Kuen Leong; Heidi Boterhoven; Beverly Fyfe; Leslie Roberts; Mahi Jasinarachchi; Natasha Willlems; Julia Wanschitz; Wolfgang Löscher; Jan De Bleecker; Guy Van den Abeele; Kathy de Koning; Katrien De Mey; Rudy Mercelis; Linda Wagemaekers; Delphine Mahieu; Philip Van Damme; Charlotte Smetcoren; Olivier Stevens; Sarah Verjans; Ann D'Hondt; Petra Tilkin; Alzira Alves de Siqueira Carvalho; Rosa Hasan; Igor Dias Brockhausen; David Feder; Daniel Ambrosio; Ana Paula Melo; Rosana Rocha; Bruno Rosa; Thabata Veiga; Luiz Augusto da Silva; Jordana Gonçalves Geraldo; Maria da Penha Morita Ananias; Erica Nogueira Coelho; Gabriel Paiva; Marina Pozo; Natalia Prando; Debora Dada Martineli Torres; Cristiani Fernanda Butinhao; Erica Coelho; Luciana Renata Cubas Volpe; Gustavo Duran; Tamires Cristina Gomes da Silva; Luiz Otavio Maia Gonçalves; Lucas Eduardo Pazetto; Luciana Souza Duca; Tomás Augusto Suriane Fialho; Maurício André Gheller Friedrich; Alexandre Guerreiro; Henrique Mohr; Maurer Pereira Martins; Daiane da Cruz Pacheco; Ana Paula Macagnan; Aline de Cassia Santos; Acary Souza Bulle Oliveira; Ana Carolina Amaral de Andrade; Marcelo Annes; Valeria Cavalcante Lino; Wladimir Pinto; Carolina Miranda; Fernanda Carrara; Iandra Souza; Angela Genge; Rami Massie; Natasha Campbell; Vera Bril; Hans Katzberg; Mehran Soltani; Eduardo Ng; Zaeem Siddiqi; Celile Phan; Derrick Blackmore; Stanislav Vohanka; Josef Bednarik; Magda Chmelikova; Marek Cierny; Stanislava Toncrova; Jana Junkerova; Barbora Kurkova; Katarina Reguliova; Olga Zapletalova; Jiri Pitha; Iveta Novakova; Michaela Tyblova; Marcela Wolfova; Ivana Jurajdova; Henning Andersen; Thomas Harbo; Lotte Vinge; Anita Mogensen; Joan Højgaard; Nanna Witting; Anne Mette Autzen; Jane Pedersen; Markus Färkkilä; Sari Atula; Anne Nyrhinen; Juha-Pekka Erälinna; Mikko Laaksonen; Olli Oksaranta; Jaana Eriksson; Tuula Harrison; Claude Desnuelle; Sabrina Sacconi; Marie-Hélène Soriani; Sonia Decressac; Julie Moutarde; Pauline Lahaut; Guilhem Solé; Gwendal Le Masson; Anne-Cécile Wielanek-Bachelet; Morgane Gaboreau; Caroline Moreau; Amy Wilson; Christophe Vial; Françoise Bouhour; Helene Gervais-Bernard; Hélène Merle; Caroline Hourquin; Arnaud Lacour; Olivier Outteryck; Patrick Vermersch; Hélène Zephir; Edouard Millois; Michel Deneve; Fabienne Deruelle; Benedikt Schoser; Stephan Wenninger; Martin Stangel; Sascha Alvermann; Stefan Gingele; Thomas Skripuletz; Kurt-Wolfram Suehs; Corinna Trebst; Karin Fricke; Sotirios Papagiannopoulos; Sevasti Bostantzopoulou; Nicholas Vlaikidis; Martha Zampaki; Nikoletta Papadopoulou; Dimos-Dimitrios Mitsikostas; Eleni Kasioti; Efstathia Mitropoulou; Despoina Charalambous; Csilla Rozsa; Melinda Horvath; Gabor Lovas; Judit Matolcsi; Gyorgyi Szabo; Brigitta Szabadosne; Laszlo Vecsei; Livia Dezsi; Edina Varga; Monika Konyane; Bella Gross; Olga Azrilin; Nelly Greenbereg; Hila Bali Kuperman; Giovanni Antonini; Matteo Garibaldi; Stefania Morino; Fernanda Troili; Antonella Di Pasquale; Alessandro Filla; Teresa Costabile; Enrico Marano; Francesco Sacca; Angela Marsil; Giorgia Puorro; Michelangelo Maestri Tassoni; Anna De Rosa; Silvia Bonanno; Carlo Antozzi; Lorenzo Maggi; Angela Campanella; Corrado Angelini; Paola Cudia; Valentina Pegoraro; Elena Pinzan; Francesca Bevilacqua; Daniele Orrico; Domenico Marco Bonifati; Amelia Evoli; Paolo Emilio Alboini; Valentina D'Amato; Raffaele Iorio; Maurizio Inghilleri; Laura Fionda; Vittorio Frasca; Elena Giacomelli; Maria Gori; Diego Lopergolo; Emanuela Onesti; GABRIELE MARIA Greco; Francesco Patti; ANDREA SALVATORE Caramma; SILVIA Messina; Ester Reggio; Cinzia Caserta; Akiyuki Uzawa; Tetsuya Kanai; Masahiro Mori; Yoko Kaneko; Akiko Kanzaki; Eri Kobayashi; Katsuhisa Masaki; Dai Matsuse; Takuya Matsushita; Taira Uehara; Misa Shimpo; Maki Jingu; Keiko Kikutake; Yumiko Nakamura; Yoshiko Sano; Yuriko Nagane; Ikuko Kamegamori; Yuko Fujii; Kazumi Futono; Tomoko Tsuda; Yuka Saito; Hidekazu Suzuki; Miyuki Morikawa; Makoto Samukawa; Sachiko Kamakura; Hirokazu Shiraishi; Teiichiro Mitazaki; Masakatsu Motomura; Akihiro Mukaino; Shunsuke Yoshimura; Shizuka Asada; Tomomi Kobashikawa; Megumi Koga; Yasuko Maeda; Kazumi Takada; Mihoko Takada Takada; Yumi Yamashita; Seiko Yoshida; Yasushi Suzuki; Tetsuya Akiyama; Koichi Narikawa; Kenichi Tsukita; Fumie Meguro; Yusuke Fukuda; Miwako Sato; Hidenori Matsuo; Takayasu Fukudome; Yuichiro Gondo; Yasuhiro Maeda; Akiko Nagaishi; Shunya Nakane; Yoshinori Okubo; Meinoshin Okumura; Soichiro Funaka; Tomohiro Kawamura; Masayuki Makamori; Masanori Takahashi; Tomoya Hasuike; Eriko Higuchi; Hisako Kobayashi; Kaori Osakada; Namie Taichi; Emiko Tsuda; Takashi Hayashi; Shin Hisahara; Tomihiro Imai; Jun Kawamata; Takashi Murahara; Masaki Saitoh; Shun Shimohama; Shuichiro Suzuki; Daisuke Yamamoto; Shingo Konno; Tomomi Imamura; Masashi Inoue; Mayumi Murata; Hiroshi Nakazora; Ritsu Nakayama; Yasuko Ikeda; Miki Ogawa; Maoko Shirane; Takashi Kanda; Motoharu Kawai; Michiaki Koga; Junichi Ogasawara; Masatoshi Omoto; Yasuteru Sano; Hideki Arima; Sachie Fukui; Shigemi Shimose; Hirokazu Shinozaki; Masanori Watanabe; Chieko Yoshikawa; Anneke van der Kooi; Marianne de Visser; Tamar Gibson; Jos Maessen; Marc de Baets; Catherine Faber; Maria Johanna Keijzers; Monique Miesen; Anna Kostera-Pruszczyk; Anna Kaminska; Byung-Jo Kim; Chang Nyoung Lee; Yong Seo Koo; Hung Youl Seok; Hoo Nam Kang; HyeJin Ra; Byoung Joon Kim; Eun Bin Cho; HyeLim Lee; Ju-Hong Min; Jinmyoung Seok; Da Yoon Koh; JuYoung Kwon; JiEun Lee; SangAe Park; Yoon-Ho Hong; Jae-Sung Lim; MiRi Kim; Seung Min Kim; Yool-hee Kim; Hyung Seok Lee; Ha Young Shin; Eun Bi Hwang; MiJu Shin; Denis Sazonov; Asya Yarmoschuk; Larisa Babenko; Nadezhda Malkova; Anna Melnikova; Denis Korobko; Evgeniya Kosykh; Dmitry Pokhabov; Yulia Nesterova; Vladislav Abramov; Victor Balyazin; Carlos Casasnovas Pons; Maria Alberti Aguilo; Christian Homedes-Pedret; Natalia Julia Palacios; Ana Lazaro; Exuperio Diez Tejedor; Mireya Fernandez-Fournier; Pedro Lopez Ruiz; Francisco Javier Rodriguez de Rivera; Maria Salvado Figueras; Josep Gamez; Maria Salvado; Elena Cortes Vicente; Jordi Diaz-Manera; Luis Querol Gutierrez; Ricardo Rojas Garcia; Nuria Vidal; Elisabet Arribas-Ibar; Fredrik Piehl; Albert Hietala; Lena Bjarbo; Christopher Lindberg; Daniel Jons; Blanka Andersson; Ihsan Sengun; Pinar Ozcelik; Celal Tuga; Muzeyyen Ugur; Cavit Boz; Didem Altiparmak; Sibel Gazioglu; Cigdem Ozen Aydin; Sevim Erdem-Ozdamar; Can Ebru Bekircan-Kurt; Ezgi Yilmaz; Nazire Pinar Acar; Yagmur Caliskan; Husnu Efendi; Seda Aydinlik; Hakan Cavus; Cansu Semiz; Ozlem Tun; Murat Terzi; Baki Dogan; Musa Kazim Onar; Sedat Sen; Tugce Kirbas Cavdar; Fiona Norwood; Aikaterini Dimitriou; Jakit Gollogly; Mohamed Mahdi-Rogers; Arshira Seddigh; Gal Maier; Faisal Sohail; Sivakumar Sathasivam; Heike Arndt; Debbie Davies; Dave Watling; Michael Rivner; J. Edward Hartmann; Brandy Quarles; Nicole Smalley; Anthony Amato; Thomas Cochrane; Mohammed Salajegheh; Kristen Roe; Katherine Amato; Shirli Toska; Gil Wolfe; Nicholas Silvestri; Kara Patrick; Karen Zakalik; Jonathan Katz; Robert Miller; Marguerite Engel; Elena Bravver; Benjamin Brooks; Sarah Plevka; Maryanne Burdette; Mohammad Sanjak; Megan Kramer; Joanne Nemeth; Clara Schommer; Vern Juel; Jeffrey Guptill; Lisa Hobson-Webb; Kate Beck; Donna Carnes; John Loor; Amanda Anderson; Dale Lange; Eliz Agopian; Jonathan Goldstein; Erin Manning; Lindsay Kaplan; Shara Holzberg; Nicole Kassebaum; Robert Pascuzzi; Cynthia Bodkin; John Kincaid; Riley Snook; Sandra Guinrich; Angela Micheels; Vinay Chaudhry; Andrea Corse; Betsy Mosmiller; Doreen Ho; Jayashri Srinivasan; Michael Vytopil; Nicholas Ventura; Stephanie Scala; Cynthia Carter; Craig Donahue; Carol Herbert; Elaine Weiner; Jonathan McKinnon; Laura Haar; Naya McKinnon; Karan Alcon; Kevin Daniels; Nadia Sattar; Dennis Jeffery; Kaitlyn McKenna; Amanda Guidon; WILLIAM DAVID Furley; Christina Dheel; Mark Levine-Weinberg; Catherine Nigro; Ericka Simpson; Stanley H Appel; Eugene Lai; Luis Lay; Milvia Pleitez; Sharon Halton; Casey Faigle; Lisa Thompson; Mark Sivak; Susan Shin; Joan Bratton; Daniel Jacobs; Gavin Brown; Ibrez Bandukwala; Morris Brown; Jennifer Kane; Ira Blount; Miriam Freimer; J. Chad Hoyle; Julie Agriesti; Julie Khoury; Tessa Marburger; Harpreet Kaur; Diana Dimitrova; Michelle Mellion; George Sachs; Brigid Crabtree; Roseann Keo; Ele Kim Perez; Sandra Taber; James Gilchrist; Angela Andoin; Taylor Darnell; Neelam Goyal; Sarada Sakamuri; Yuen T So; Lesly Welsh Welsh; Ratna Bhavaraju-Sanka; Alejandro Tobon Gonzalez; Floyd Jones; Amy Saklad; Sharon Nations; Jaya Trivedi; Steve Hopkins; Mohamed Kazamel; Mohammad Alsharabati; Liang Lu; Sandi Mumfrey-Thomas; Amy Woodall; David Richman; Janelle Butters; Molly Lindsay; Tahseen Mozaffar; Tiyonnoh Cash; Namita Goyal; Gulmohor Roy; Veena Mathew; Fatima Maqsood; Brian Minton; H. James Jones; Jeffrey Rosenfeld; Rebekah Garcia; Sonia Garcia; Laura Echevarria; Michael Pulley; Shachie Aranke; Alan Ross Berger; Jaimin Shah; Yasmeen Shabbir; Lisa Smith; Mary Varghese; Laurie Gutmann; Ludwig Gutmann; Andrea Swenson; Heena Olalde; Charlene Hafer-Macko; Justin Kwan; Lindsay Zilliox; Karen Callison; Beth DiSanzo; Kerry Naunton; Martin Bilsker; Khema Sharma; Eliana Reyes; Anne Cooley; Sara-Claude Michon; Julie Steele; Chafic Karam Karam; Manisha Chopra; Shawn Bird; Jacob Kaufman; Nichole Gallatti; Tuan Vu; Lara Katzin; Terry McClain; Brittany Harvey; Adam Hart; Kristin Huynh; Said Beydoun; Amaiak Chilingaryan; Brian Droker; Frank Lin; Akshay Shah; Anh Tran; Salma Akhter; Ali Malekniazi; Rup Tandan; Michael Hehir; Waqar Waheed; Shannon Lucy; Michael Weiss; Jane Distad; Sharon Downing; Susan Strom; Robert Lisak; Evanthia Bernitsas; Omar Khan; Shitiz Kumar Sriwastava; Alexandros Tselis; Kelly Jia; Tulio Bertorini; Thomas Arnold; Kendrick Henderson; Rekha Pillai; Ye Liu; Lauren Wheeler; Jasmine Hewlett; Mollie Vanderhook; Daniel Dicapua; Benison Keung; Aditya Kumar; Huned Patwa; Kimberly Robeson; Joan Nye; Hong Vu

doi:10.1016/S1474-4422(17)30369-1

$Safety and efficacy of eculizumab in anti-acetylcholine receptor antibody-positive refractory generalised myasthenia gravis (REGAIN): a phase 3, randomised, double-blind, placebo-controlled, multicentre study$

Journal article

Safety and efficacy of eculizumab in anti-acetylcholine receptor antibody-positive refractory generalised myasthenia gravis (REGAIN): a phase 3, randomised, double-blind, placebo-controlled, multicentre study

James F Howard, Kimiaki Utsugisawa, Michael Benatar, Hiroyuki Murai, Richard J Barohn, Isabel Illa, Saiju Jacob, John Vissing, Ted M Burns, John T Kissel, …

journal:LANCET NEUROLOGY

2017

DOI: https://doi.org/10.1016/S1474-4422(17)30369-1

Abstract

Neurology (clinical)

Background Complement is likely to have a role in refractory generalised myasthenia gravis, but no approved therapies specifically target this system. Results from a phase 2 study suggested that eculizumab, a terminal complement inhibitor, produced clinically meaningful improvements in patients with anti-acetylcholine receptor antibody-positive refractory generalised myasthenia gravis. We further assessed the efficacy and safety of eculizumab in this patient population in a phase 3 trial. Methods We did a phase 3, randomised, double-blind, placebo-controlled, multicentre study (REGAIN) in 76 hospitals and specialised clinics in 17 countries across North America, Latin America, Europe, and Asia. Eligible patients were aged at least 18 years, with a Myasthenia Gravis-Activities of Daily Living (MG-ADL) score of 6 or more, Myasthenia Gravis Foundation of America (MGFA) class IIâ€“IV disease, vaccination against Neisseria meningitides, and previous treatment with at least two immunosuppressive therapies or one immunosuppressive therapy and chronic intravenous immunoglobulin or plasma exchange for 12 months without symptom control. Patients with a history of thymoma or thymic neoplasms, thymectomy within 12 months before screening, or use of intravenous immunoglobulin or plasma exchange within 4 weeks before randomisation, or rituximab within 6 months before screening, were excluded. We randomly assigned participants (1:1) to either intravenous eculizumab or intravenous matched placebo for 26 weeks. Dosing for eculizumab was 900 mg on day 1 and at weeks 1, 2, and 3; 1200 mg at week 4; and 1200 mg given every second week thereafter as maintenance dosing. Randomisation was done centrally with an interactive voice or web-response system with patients stratified to one of four groups based on MGFA disease classification. Where possible, patients were maintained on existing myasthenia gravis therapies and rescue medication was allowed at the study physician's discretion. Patients, investigators, staff, and outcome assessors were masked to treatment assignment. The primary efficacy endpoint was the change from baseline to week 26 in MG-ADL total score measured by worst-rank ANCOVA. The efficacy population set was defined as all patients randomly assigned to treatment groups who received at least one dose of study drug, had a valid baseline MG-ADL assessment, and at least one post-baseline MG-ADL assessment. The safety analyses included all randomly assigned patients who received eculizumab or placebo. This trial is registered with ClinicalTrials.gov, number NCT01997229. Findings Between April 30, 2014, and Feb 19, 2016, we randomly assigned and treated 125 patients, 62 with eculizumab and 63 with placebo. The primary analysis showed no significant difference between eculizumab and placebo (least-squares mean rank 56Â·6 [SEM 4Â·5] vs 68Â·3 [4Â·5]; rank-based treatment difference âˆ’11Â·7, 95% CI âˆ’24Â·3 to 0Â·96; p=0Â·0698). No deaths or cases of meningococcal infection occurred during the study. The most common adverse events in both groups were headache and upper respiratory tract infection (ten [16%] for both events in the eculizumab group and 12 [19%] for both in the placebo group). Myasthenia gravis exacerbations were reported by six (10%) patients in the eculizumab group and 15 (24%) in the placebo group. Six (10%) patients in the eculizumab group and 12 (19%) in the placebo group required rescue therapy. Interpretation The change in the MG-ADL score was not statistically significant between eculizumab and placebo, as measured by the worst-rank analysis. Eculizumab was well tolerated. The use of a worst-rank analytical approach proved to be an important limitation of this study since the secondary and sensitivity analyses results were inconsistent with the primary endpoint result; further research into the role of complement is needed. Funding Alexion Pharmaceuticals.

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Title: Safety and efficacy of eculizumab in anti-acetylcholine receptor antibody-positive refractory generalised myasthenia gravis (REGAIN): a phase 3, randomised, double-blind, placebo-controlled, multicentre study
Creators: James F Howard - University of North Carolina at Chapel Hill
Kimiaki Utsugisawa - National Hospital Organization Hanamaki Hospital
Michael Benatar - University of Miami
Hiroyuki Murai - International University of Health and Welfare
Richard J Barohn - University of Kansas Medical Center
Isabel Illa
Saiju Jacob - Wellcome Trust
John Vissing - Rigshospitalet
Ted M Burns - University of Virginia Health System
John T Kissel - The Ohio State University
Srikanth Muppidi - Stanford University
Richard J Nowak - Yale University
Fanny O'Brien
Jing-Jing Wang
Renato Mantegazza - Fondazione IRCCS Istituto Neurologico Carlo Besta
Claudio Gabriel Mazia
Miguel Wilken
Carolina Ortea
Juliet Saba
Marcelo Rugiero
Mariela Bettini
Gonzalo Vidal
Alejandra Dalila Garcia
Phillipa Lamont
Wai-Kuen Leong
Heidi Boterhoven
Beverly Fyfe
Leslie Roberts
Mahi Jasinarachchi
Natasha Willlems
Julia Wanschitz
Wolfgang Löscher
Jan De Bleecker
Guy Van den Abeele
Kathy de Koning
Katrien De Mey
Rudy Mercelis
Linda Wagemaekers
Delphine Mahieu
Philip Van Damme
Charlotte Smetcoren
Olivier Stevens
Sarah Verjans
Ann D'Hondt
Petra Tilkin
Alzira Alves de Siqueira Carvalho
Rosa Hasan
Igor Dias Brockhausen
David Feder
Daniel Ambrosio
Ana Paula Melo
Rosana Rocha
Bruno Rosa
Thabata Veiga
Luiz Augusto da Silva
Jordana Gonçalves Geraldo
Maria da Penha Morita Ananias
Erica Nogueira Coelho
Gabriel Paiva
Marina Pozo
Natalia Prando
Debora Dada Martineli Torres
Cristiani Fernanda Butinhao
Erica Coelho
Luciana Renata Cubas Volpe
Gustavo Duran
Tamires Cristina Gomes da Silva
Luiz Otavio Maia Gonçalves
Lucas Eduardo Pazetto
Luciana Souza Duca
Tomás Augusto Suriane Fialho
Maurício André Gheller Friedrich
Alexandre Guerreiro
Henrique Mohr
Maurer Pereira Martins
Daiane da Cruz Pacheco
Ana Paula Macagnan
Aline de Cassia Santos
Acary Souza Bulle Oliveira
Ana Carolina Amaral de Andrade
Marcelo Annes
Valeria Cavalcante Lino
Wladimir Pinto
Carolina Miranda
Fernanda Carrara
Iandra Souza
Angela Genge
Rami Massie
Natasha Campbell
Vera Bril
Hans Katzberg
Mehran Soltani
Eduardo Ng - Alexion Pharmaceuticals
Zaeem Siddiqi
Celile Phan
Derrick Blackmore
Stanislav Vohanka
Josef Bednarik
Magda Chmelikova
Marek Cierny
Stanislava Toncrova
Jana Junkerova
Barbora Kurkova
Katarina Reguliova
Olga Zapletalova
Jiri Pitha
Iveta Novakova
Michaela Tyblova
Marcela Wolfova
Ivana Jurajdova
Henning Andersen
Thomas Harbo
Lotte Vinge
Anita Mogensen
Joan Højgaard
Nanna Witting
Anne Mette Autzen
Jane Pedersen
Markus Färkkilä
Sari Atula
Anne Nyrhinen
Juha-Pekka Erälinna
Mikko Laaksonen
Olli Oksaranta
Jaana Eriksson
Tuula Harrison
Claude Desnuelle
Sabrina Sacconi
Marie-Hélène Soriani
Sonia Decressac
Julie Moutarde
Pauline Lahaut
Guilhem Solé
Gwendal Le Masson
Anne-Cécile Wielanek-Bachelet
Morgane Gaboreau
Caroline Moreau
Amy Wilson
Christophe Vial
Françoise Bouhour
Helene Gervais-Bernard
Hélène Merle
Caroline Hourquin
Arnaud Lacour
Olivier Outteryck
Patrick Vermersch
Hélène Zephir
Edouard Millois
Michel Deneve
Fabienne Deruelle
Benedikt Schoser
Stephan Wenninger
Martin Stangel
Sascha Alvermann
Stefan Gingele
Thomas Skripuletz
Kurt-Wolfram Suehs
Corinna Trebst
Karin Fricke
Sotirios Papagiannopoulos
Sevasti Bostantzopoulou
Nicholas Vlaikidis
Martha Zampaki
Nikoletta Papadopoulou
Dimos-Dimitrios Mitsikostas
Eleni Kasioti
Efstathia Mitropoulou
Despoina Charalambous
Csilla Rozsa
Melinda Horvath
Gabor Lovas
Judit Matolcsi
Gyorgyi Szabo
Brigitta Szabadosne
Laszlo Vecsei
Livia Dezsi
Edina Varga
Monika Konyane
Bella Gross
Olga Azrilin
Nelly Greenbereg
Hila Bali Kuperman
Giovanni Antonini
Matteo Garibaldi
Stefania Morino
Fernanda Troili
Antonella Di Pasquale
Alessandro Filla
Teresa Costabile
Enrico Marano
Francesco Sacca
Angela Marsil
Giorgia Puorro
Michelangelo Maestri Tassoni
Anna De Rosa
Silvia Bonanno
Carlo Antozzi
Lorenzo Maggi
Angela Campanella
Corrado Angelini
Paola Cudia
Valentina Pegoraro
Elena Pinzan
Francesca Bevilacqua
Daniele Orrico
Domenico Marco Bonifati
Amelia Evoli
Paolo Emilio Alboini
Valentina D'Amato
Raffaele Iorio
Maurizio Inghilleri
Laura Fionda
Vittorio Frasca
Elena Giacomelli
Maria Gori
Diego Lopergolo
Emanuela Onesti
GABRIELE MARIA Greco
Francesco Patti
ANDREA SALVATORE Caramma
SILVIA Messina
Ester Reggio
Cinzia Caserta
Akiyuki Uzawa
Tetsuya Kanai
Masahiro Mori
Yoko Kaneko
Akiko Kanzaki
Eri Kobayashi
Katsuhisa Masaki
Dai Matsuse
Takuya Matsushita
Taira Uehara
Misa Shimpo
Maki Jingu
Keiko Kikutake
Yumiko Nakamura
Yoshiko Sano
Yuriko Nagane
Ikuko Kamegamori
Yuko Fujii
Kazumi Futono
Tomoko Tsuda
Yuka Saito
Hidekazu Suzuki
Miyuki Morikawa
Makoto Samukawa
Sachiko Kamakura
Hirokazu Shiraishi
Teiichiro Mitazaki
Masakatsu Motomura
Akihiro Mukaino
Shunsuke Yoshimura
Shizuka Asada
Tomomi Kobashikawa
Megumi Koga
Yasuko Maeda
Kazumi Takada
Mihoko Takada Takada
Yumi Yamashita
Seiko Yoshida
Yasushi Suzuki
Tetsuya Akiyama
Koichi Narikawa
Kenichi Tsukita
Fumie Meguro
Yusuke Fukuda
Miwako Sato
Hidenori Matsuo
Takayasu Fukudome
Yuichiro Gondo
Yasuhiro Maeda
Akiko Nagaishi
Shunya Nakane
Yoshinori Okubo
Meinoshin Okumura
Soichiro Funaka
Tomohiro Kawamura
Masayuki Makamori
Masanori Takahashi
Tomoya Hasuike
Eriko Higuchi
Hisako Kobayashi
Kaori Osakada
Namie Taichi
Emiko Tsuda
Takashi Hayashi
Shin Hisahara
Tomihiro Imai
Jun Kawamata
Takashi Murahara
Masaki Saitoh
Shun Shimohama
Shuichiro Suzuki
Daisuke Yamamoto
Shingo Konno
Tomomi Imamura
Masashi Inoue
Mayumi Murata
Hiroshi Nakazora
Ritsu Nakayama
Yasuko Ikeda
Miki Ogawa
Maoko Shirane
Takashi Kanda
Motoharu Kawai
Michiaki Koga
Junichi Ogasawara
Masatoshi Omoto
Yasuteru Sano
Hideki Arima
Sachie Fukui
Shigemi Shimose
Hirokazu Shinozaki
Masanori Watanabe
Chieko Yoshikawa
Anneke van der Kooi
Marianne de Visser
Tamar Gibson
Jos Maessen
Marc de Baets
Catherine Faber
Maria Johanna Keijzers
Monique Miesen
Anna Kostera-Pruszczyk
Anna Kaminska
Byung-Jo Kim
Chang Nyoung Lee
Yong Seo Koo
Hung Youl Seok
Hoo Nam Kang
HyeJin Ra - International University of Health and Welfare
Byoung Joon Kim - International University of Health and Welfare
Eun Bin Cho
HyeLim Lee
Ju-Hong Min
Jinmyoung Seok
Da Yoon Koh
JuYoung Kwon
JiEun Lee
SangAe Park
Yoon-Ho Hong
Jae-Sung Lim
MiRi Kim - International University of Health and Welfare
Seung Min Kim - International University of Health and Welfare
Yool-hee Kim - International University of Health and Welfare
Hyung Seok Lee
Ha Young Shin
Eun Bi Hwang
MiJu Shin
Denis Sazonov
Asya Yarmoschuk
Larisa Babenko
Nadezhda Malkova
Anna Melnikova
Denis Korobko
Evgeniya Kosykh
Dmitry Pokhabov
Yulia Nesterova
Vladislav Abramov
Victor Balyazin
Carlos Casasnovas Pons
Maria Alberti Aguilo
Christian Homedes-Pedret
Natalia Julia Palacios
Ana Lazaro
Exuperio Diez Tejedor
Mireya Fernandez-Fournier
Pedro Lopez Ruiz
Francisco Javier Rodriguez de Rivera
Maria Salvado Figueras
Josep Gamez
Maria Salvado
Elena Cortes Vicente
Jordi Diaz-Manera
Luis Querol Gutierrez
Ricardo Rojas Garcia
Nuria Vidal
Elisabet Arribas-Ibar
Fredrik Piehl
Albert Hietala
Lena Bjarbo
Christopher Lindberg
Daniel Jons
Blanka Andersson
Ihsan Sengun
Pinar Ozcelik
Celal Tuga
Muzeyyen Ugur
Cavit Boz
Didem Altiparmak
Sibel Gazioglu
Cigdem Ozen Aydin
Sevim Erdem-Ozdamar
Can Ebru Bekircan-Kurt
Ezgi Yilmaz
Nazire Pinar Acar
Yagmur Caliskan
Husnu Efendi
Seda Aydinlik
Hakan Cavus
Cansu Semiz
Ozlem Tun
Murat Terzi
Baki Dogan
Musa Kazim Onar
Sedat Sen
Tugce Kirbas Cavdar
Fiona Norwood
Aikaterini Dimitriou
Jakit Gollogly
Mohamed Mahdi-Rogers
Arshira Seddigh
Gal Maier
Faisal Sohail
Sivakumar Sathasivam
Heike Arndt
Debbie Davies
Dave Watling
Michael Rivner - University of Miami
J. Edward Hartmann
Brandy Quarles
Nicole Smalley
Anthony Amato
Thomas Cochrane
Mohammed Salajegheh
Kristen Roe
Katherine Amato
Shirli Toska
Gil Wolfe
Nicholas Silvestri
Kara Patrick
Karen Zakalik
Jonathan Katz
Robert Miller
Marguerite Engel
Elena Bravver
Benjamin Brooks
Sarah Plevka
Maryanne Burdette
Mohammad Sanjak
Megan Kramer
Joanne Nemeth
Clara Schommer
Vern Juel
Jeffrey Guptill
Lisa Hobson-Webb
Kate Beck
Donna Carnes
John Loor - The Ohio State University
Amanda Anderson
Dale Lange
Eliz Agopian
Jonathan Goldstein
Erin Manning
Lindsay Kaplan
Shara Holzberg
Nicole Kassebaum
Robert Pascuzzi
Cynthia Bodkin
John Kincaid - The Ohio State University
Riley Snook
Sandra Guinrich
Angela Micheels
Vinay Chaudhry
Andrea Corse
Betsy Mosmiller
Doreen Ho - University of North Carolina at Chapel Hill
Jayashri Srinivasan
Michael Vytopil - University of Miami
Nicholas Ventura
Stephanie Scala
Cynthia Carter
Craig Donahue
Carol Herbert
Elaine Weiner
Jonathan McKinnon
Laura Haar
Naya McKinnon
Karan Alcon
Kevin Daniels
Nadia Sattar
Dennis Jeffery
Kaitlyn McKenna
Amanda Guidon
WILLIAM DAVID Furley
Christina Dheel
Mark Levine-Weinberg
Catherine Nigro
Ericka Simpson
Stanley H Appel
Eugene Lai
Luis Lay
Milvia Pleitez
Sharon Halton
Casey Faigle
Lisa Thompson
Mark Sivak
Susan Shin
Joan Bratton
Daniel Jacobs
Gavin Brown
Ibrez Bandukwala
Morris Brown
Jennifer Kane
Ira Blount
Miriam Freimer
J. Chad Hoyle
Julie Agriesti
Julie Khoury
Tessa Marburger
Harpreet Kaur
Diana Dimitrova
Michelle Mellion
George Sachs
Brigid Crabtree
Roseann Keo
Ele Kim Perez
Sandra Taber
James Gilchrist - University of North Carolina at Chapel Hill
Angela Andoin
Taylor Darnell
Neelam Goyal
Sarada Sakamuri
Yuen T So
Lesly Welsh Welsh
Ratna Bhavaraju-Sanka
Alejandro Tobon Gonzalez
Floyd Jones
Amy Saklad
Sharon Nations
Jaya Trivedi
Steve Hopkins
Mohamed Kazamel
Mohammad Alsharabati
Liang Lu
Sandi Mumfrey-Thomas
Amy Woodall
David Richman
Janelle Butters
Molly Lindsay
Tahseen Mozaffar
Tiyonnoh Cash
Namita Goyal
Gulmohor Roy - International University of Health and Welfare
Veena Mathew
Fatima Maqsood
Brian Minton
H. James Jones
Jeffrey Rosenfeld
Rebekah Garcia
Sonia Garcia
Laura Echevarria
Michael Pulley - University of Miami
Shachie Aranke
Alan Ross Berger
Jaimin Shah
Yasmeen Shabbir
Lisa Smith
Mary Varghese
Laurie Gutmann
Ludwig Gutmann
Andrea Swenson
Heena Olalde
Charlene Hafer-Macko
Justin Kwan
Lindsay Zilliox
Karen Callison
Beth DiSanzo
Kerry Naunton
Martin Bilsker
Khema Sharma
Eliana Reyes
Anne Cooley
Sara-Claude Michon
Julie Steele
Chafic Karam Karam
Manisha Chopra
Shawn Bird
Jacob Kaufman - Wellcome Trust
Nichole Gallatti
Tuan Vu
Lara Katzin
Terry McClain
Brittany Harvey
Adam Hart
Kristin Huynh
Said Beydoun
Amaiak Chilingaryan
Brian Droker
Frank Lin
Akshay Shah
Anh Tran
Salma Akhter
Ali Malekniazi
Rup Tandan
Michael Hehir - University of Miami
Waqar Waheed
Shannon Lucy
Michael Weiss - University of Miami
Jane Distad
Sharon Downing
Susan Strom
Robert Lisak
Evanthia Bernitsas
Omar Khan
Shitiz Kumar Sriwastava
Alexandros Tselis
Kelly Jia
Tulio Bertorini
Thomas Arnold
Kendrick Henderson
Rekha Pillai
Ye Liu
Lauren Wheeler
Jasmine Hewlett
Mollie Vanderhook
Daniel Dicapua
Benison Keung
Aditya Kumar
Huned Patwa
Kimberly Robeson
Joan Nye
Hong Vu
Publication Details: journal:LANCET NEUROLOGY
Identifiers: 991006150043902656
Academic Unit: Neurology
Language: English
Resource Type: Journal article

Safety and efficacy of eculizumab in anti-acetylcholine receptor antibody-positive refractory generalised myasthenia gravis (REGAIN): a phase 3, randomised, double-blind, placebo-controlled, multicentre study

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