Zilucoplan: A Promising Potential Treatment for Myasthenia Gravis

Myasthenia gravis (MG), which literally translates to “grave muscle weakness,” is a neuromuscular disorder that causes weakness in the skeletal muscles. This is caused by an irregularity in how the muscles receive transmission of nerve signals.

In the United States, about 37 out of every 100,000 people are affected by MG, and there are more than 700,000 estimated cases globally. Though MG can impact anyone, women under 40 and men over 60 are most at risk.

MG can present a myriad of symptoms. These include:

• Eye muscle weakness, or drooping of one or both eyes
• Blurry vision
• Difficulty swallowing
• Weakness in extremities (arms, legs, hands, fingers)

There is currently no cure for MG. However, researchers are working to develop new treatment options and increase rates of early detection.

Recent Research on Zilucoplan in MG Patients

Findings from a recent study presented at the 2024 American Association of Neuromuscular & Electrodiagnostic Medicine Annual Meeting show zilucoplan may be a safe and effective treatment for patients with MG, largely because of its ability to bind to the protein complement component 5 and inhibit the formation of membrane attack complexes.

The study focused on 26 MG patients who received zilucoplan injections daily for 12 weeks. The 23 patients who completed the study reported improved MG symptoms and elevated health scores. Patients switching to this treatment after taking ravulizumab saw a particularly noticeable benefit.

Though some patients experienced mild side effects, zilucoplan generally showed promise as a treatment option for MG.

Side Effects of Zilucoplan

Zilucoplan is a subcutaneous medication, meaning that it is injected under the skin. As a result, patients may experience pain or bruising around the site of injection.

Other side effects of zilucoplan include:

• Headache
• Diarrhea
• Worsening MG symptoms

Patients experiencing exacerbated MG symptoms should contact their doctor immediately. Other side effects can usually be managed with over-the-counter medications.

Managing MG with Lifestyle Changes

In tandem with medication, certain lifestyle changes can play a significant role in successfully managing symptoms of MG.

• Exercise: Regular light to moderate exercise may be beneficial for those with MG. Exercise is safe for many MG patients, though physicians should approve any substantial changes to one’s training regimen. Patients are encouraged to undergo physical therapy for improved muscle function.
• Speech Therapy: In MG, muscles in the throat, mouth, and chest can feel weak, significantly impacting one’s speech and their ability to swallow. Patients experiencing slurred speech can benefit greatly from speech therapy, which can include swallowing therapy as well.
• Clean Eating: Some medications that treat MG can cause decreased appetite. For this reason, patients are encouraged to consume whole, nutrient-dense foods that promote optimal body function. These include fruits, vegetables, and lean meats.

Conclusion

MG is a challenging neuromuscular disorder that significantly alters patients’ lives. With medications like zilucoplan and healthy lifestyle changes, patients can successfully manage their symptoms and continue living normal lives with their condition.

References:

U.S. Department of Health and Human Services. (n.d.). Myasthenia Gravis. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/health-information/disorders/myasthenia-gravis

Shirley, M. (2024, January). Zilucoplan: First approval. Drugs. https://pmc.ncbi.nlm.nih.gov/articles/PMC10925559/

JF;, H. (n.d.). Myasthenia gravis: The role of complement at the Neuromuscular Junction. Annals of the New York Academy of Sciences. https://pubmed.ncbi.nlm.nih.gov/29266249/

Overview of mg. Myasthenia Gravis Foundation of America. (2024, October 2). https://myasthenia.org/understanding-mg/overview-mg/#:~:text=In%20the%20US%2C%20it%20is,have%20better%20tools%20for%20diagnosis.

Gilhus, N. E. (2020, December 18). Physical training and exercise in myasthenia gravis. Neuromuscular Disorders. https://www.sciencedirect.com/science/article/abs/pii/S0960896620306982