Influence of Efgartigimod on Curative Efficacy and Inflammation Factors of Patients with Long Segmental Myelitis

The paper aims to evaluate the efficacy and impact of efgartigimod on clinical outcomes and inflammatory markers in patients with antibody-negative long-segment myelitis (LETM).This retrospective study enrolled 47 patients diagnosed with antibody-negative LETM, including 36 in the control group who received methylprednisolone alone and 11 in the observation group who received a combination of efgartigimod and methylprednisolone. Comparisons of the expanded disability status scale (EDSS), clinical frailty scale (CFS), and Health Survey Short Form-36 (SF-36) scores between the two groups were conducted. Concentrations of interleukin-6 (IL-6), IL-10, and IL-41 were detected using enzyme-linked immunosorbent assay (ELISA), and their correlations with EDSS scores were also evaluated. The potential predictors of therapeutic efficacy were identified using univariate and multivariate logistic regression analyses.Efgartigimod significantly reduced EDSS and CFS scores after 1 month of treatment, with the observation group demonstrating greater improvements than the control group. Efgartigimod improved the quality of life as assessed by the SF-36, with significant increases in physical functioning (PF) and vitality (VT) scores in the observation group (p < 0.05). Efgartigimod decreased serum cytokine (IL-41, IL-10, and IL-6) levels and EDSS scores at the time of treatment (p < 0.05). Serum cytokine levels were positively correlated with EDSS scores. The group (treatment strategy) and length of the involved segment were predictive factors of drug efficacy.Efgartigimod demonstrated significant efficacy and safety for the treatment of LETM. Efgartigimod lowered serum concentrations of IL-6, IL-41, and IL-10 in LETM patients. The levels of IL-6, IL-41, and IL-10 correlated with EDSS scores, indicating their potential as predictive biomarkers for disease severity and treatment efficacy in LETM.