Current status and challenges of biologic targeted therapy for myasthenia gravis in China.

Abstract

Myasthenia gravis (MG) is an autoimmune neuromuscular disorder posing substantial disease burden in China, with significant impacts on patient quality of life. While conventional immunosuppressants remain fundamental therapy, biologic targeted agents-including B-cell targeting drugs, complement C5 inhibitors, FcRn antagonists, and IL-6R inhibitors-have brought major advances, especially for refractory and MuSK-antibody-positive MG. Increasing availability in China has demonstrated promising clinical outcomes, yet substantial barriers remain. Challenges include high drug costs, limited insurance access, insufficient multicenter clinical evidence, and disparities in physician adoption. China's research is improving, exemplified by local innovation with telitacicept and active participation in global trials, though most biologics remain imported. To maximize benefits, clinical application should be guided by antibody subtype and immunopathology, with individualized, dynamic regimens balancing efficacy, safety, and affordability. High-quality randomized trials, updated guidelines, broader insurance coverage, and R&D investment are urgently needed to promote individualized and accessible MG care in China.