Rapid Symptomatic Improvement and Long-Term Minimal Symptom Expression in a Myasthenia Gravis Patient Treated With Zilucoplan Without Maintenance Cholinesterase Inhibitors, Corticosteroids, or Immunosuppressants: A Case Report

Myasthenia gravis (MG) is an autoimmune neuromuscular disorder, often requiring long-term immunosuppressive treatment. Although complement C5 inhibitors, such as zilucoplan, have shown robust efficacy in clinical trials, evidence of their use without maintenance cholinesterase inhibitors, corticosteroids, or other immunosuppressants remains limited. In this report, I describe a woman in her late 60s with anti-acetylcholine receptor antibody-positive generalized MG, who achieved rapid symptomatic improvement and minimal symptom expression with zilucoplan. Clinical stability was sustained for at least one and a half years without concomitant cholinesterase inhibitors, corticosteroids, or other immunosuppressants. This case suggests that zilucoplan may represent an effective and durable treatment option for generalized MG.