The effectiveness of C5 inhibition in human trials, which will be discussed later in this review, offers further compelling evidence that complement is a critical mediator of MG. The relative contribution of non-complement-mediated mechanisms to human MG is poorly defined.

Preclinical studies have confirmed the efficacy of complement inhibition in ameliorating MG symptoms. Eculizumab, an antibody directed towards C5, has recently been approved for the treatment of AChR antibody-positive gMG. Other complement inhibitors, targeting C5 as well, are currently under phase III study.

2023年的8月30日，阿斯利康旗下研发的第三代C5抑制剂Gefurulimab在中国开展了 III期临床试验ALXN1720-MG-301（登记号：CTR20232711），目标群体为全身型重症肌无力患者。

2023年5月30日 · New biologics are rapidly opening up target-specific therapeutic opportunities for myasthenia gravis (MG) — an autoimmune disease caused by antibodies against neuromuscular junction proteins.

2024年12月25日 · Eculizumab, an inhibitor to target human C5 component of the complement cascade, is considered a treatment option for refractory generalized MG (gMG). Objectives: To explore the safety and efficacy of eculizumab in patients with TAMG.

2017年12月21日 · Current MG therapies do not target complement directly. Eculizumab is a humanized monoclonal antibody that inhibits cleavage of complement protein C5, preventing MAC formation. Eculizumab treatment improved symptoms compared with placebo in a phase II study in patients with refractory gMG.

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Crovalimab是新一代抗补体C5抗体，由Chugai公司使用回收抗体（Smart-Ig）工程化改造技术研发。其通过结合C5 β链上的表位（与eculizumab和ravulizumab结合表位不同），阻断C5裂解为C5a和C5b，抑制补体活化，其适应症为PNH。

Thus far, only eculizumab, an antibody against C5, has reached the clinic. We review the present status of monoclonal antibody-based treatments for MG that have entered human testing and offer the promise to transform treatment of MG.

Ravulizumab 是一种人源化单克隆抗体，以高亲和力特异性结合人末端补体蛋白 C5，防止神经肌肉传递中断，可能是通 过抑制膜攻击复合物介导的神经肌肉接头破坏。 Ravulizumab 的设计目的是在较长（8 周）的给药间隔内维持治疗性血清浓度。