Myasthenia Gravis Treatments Compared
7 FDA-approved drugs, side by side from the current prescribing labels. Newest label Aug 2026. Checked October 1, 2026.
The full Myasthenia Gravis guide, with open trials and help paying →
Seven targeted drugs are FDA-approved for generalized myasthenia gravis, and they fall into 3 groups. Vyvgart, Rystiggo and Imaavy block FcRn to clear the harmful antibodies; Soliris, Ultomiris and Zilbrysq block complement protein C5; Uplizna removes the B cells that make the antibodies. Five are clinic infusions, Rystiggo is a pump infusion under the skin given by a clinician, Zilbrysq is a daily self-injection, and Vyvgart also comes as a weekly under-the-skin version. The 3 complement blockers carry a boxed warning for meningococcal infection and require vaccination. Bkemv and Epysqli, biosimilar versions of Soliris, are also approved for adults with AChR-positive generalized MG. Every pivotal trial measured the MG-ADL daily-living score against placebo, with drug-minus-placebo differences of 1.5 to 2.6 points, but the trials used different time points and populations, so the numbers do not rank the drugs.
7 approved myasthenia gravis treatments at a glance
How each drug is given, how often, who it is approved for and when it was first approved, from the current FDA label.
A year on each myasthenia gravis treatment
Every dose in a year, drawn to the label schedule, so you can see at a glance how often each one is given.
Counts follow the label schedule for a full year on the maintenance dose. Drugs given in cycles or adjusted to blood tests have no fixed count, so their schedule is written out instead.
What the pivotal myasthenia gravis trials showed
The primary result from the trial each FDA approval rests on, as reported on the label.
Myasthenia Gravis treatment side effects and warnings
Soliris, Zilbrysq and Ultomiris carry a boxed warning, the FDA's strongest. The rest list their main precautions. Side effect rates show how many people in each drug's trials reported each one, whether or not the drug caused it.
Help paying for myasthenia gravis treatment
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Myasthenia Gravis treatment questions people ask
Imaavy vs Ultomiris: what is the difference for generalized myasthenia gravis?
Imaavy lowers the harmful antibodies themselves, while Ultomiris blocks complement, the part of the immune system those antibodies switch on to damage the nerve-muscle junction.
Who it is for: Imaavy is approved for adults and children 12 and older who are AChR or MuSK antibody positive. Ultomiris is for adults who are AChR antibody positive only.
How it is given: Imaavy is an IV infusion every 2 weeks after a larger starting dose, at least 15 minutes for each maintenance dose. Ultomiris is an IV infusion every 8 weeks after a weight-based loading dose and a first maintenance dose 2 weeks later.
Safety: Ultomiris carries a boxed warning for serious meningococcal infections, requires meningococcal vaccination and is available only through a REMS program. Imaavy has no boxed warning; its label warns about infections, allergic reactions including anaphylaxis, and infusion reactions.
Trial results: Imaavy lowered the MG-ADL daily-living score 1.5 points more than placebo over weeks 22 to 24, and Ultomiris 1.6 points more at week 26. The trials enrolled different patients, so these numbers do not show which drug works better.
More: Imaavy drug page and Ultomiris drug page
Source: FDA label for Imaavy, DailyMed, effective August 2026; FDA label for Ultomiris, DailyMed, effective October 2025
Imaavy vs Soliris: what is the difference for generalized myasthenia gravis?
Imaavy lowers the harmful antibodies, while Soliris blocks complement, and Soliris is the older, shorter-acting version of Ultomiris from the same company.
Who it is for: Imaavy covers AChR or MuSK antibody positive patients 12 and older. Soliris covers AChR antibody positive patients 6 and older, the youngest age of any myasthenia gravis drug on this page.
How it is given: Both are IV infusions every 2 weeks once treatment is underway. Imaavy starts with 1 larger dose; Soliris in adults starts with 4 weekly doses and a fifth dose at week 5.
Safety: Soliris carries the same boxed warning as Ultomiris for serious meningococcal infections, with required vaccination and a REMS program. Imaavy has no boxed warning.
Trial results: Soliris lowered the MG-ADL score 1.9 points more than placebo at week 26 in REGAIN, which enrolled people who had already failed 2 or more immunosuppressants. Imaavy lowered it 1.5 points more over weeks 22 to 24 in a broader population.
More: Imaavy drug page and Soliris drug page
Source: FDA label for Imaavy, DailyMed, effective August 2026; FDA label for Soliris, DailyMed, effective July 2026
Is Imaavy better than Ultomiris or Soliris?
No trial has compared them directly, so there is no evidence that one works better than the others for everyone.
What the trials show: Each drug beat placebo in its own trial by 1.5 to 1.9 points on the MG-ADL daily-living score, but the trials used different patients and time points, so the numbers cannot be ranked.
What usually decides it: Antibody type, since only Imaavy of the 3 is approved for MuSK-positive disease. Age, since Soliris starts at 6, Imaavy at 12 and Ultomiris at 18. How often you can get to an infusion center, every 2 weeks for Imaavy and Soliris against every 8 weeks for Ultomiris. Whether meningococcal vaccination and the infection risk of complement blockers fit your situation.
Next step: The table on this page puts all 7 approved myasthenia gravis drugs side by side for that conversation with your neurologist.
Source: FDA label for Imaavy, DailyMed, effective August 2026; FDA label for Ultomiris, DailyMed, effective October 2025; FDA label for Soliris, DailyMed, effective July 2026; ClinicalTrials.gov search for nipocalimab with ravulizumab or eculizumab, October 2026, no head-to-head trials found
What is the newest treatment for myasthenia gravis?
The most recent FDA approval in generalized myasthenia gravis came on May 8, 2026, when the FDA expanded Vyvgart and Vyvgart Hytrulo to all adults with generalized MG, including people with no detectable AChR, MuSK or LRP4 antibodies. Before that, Uplizna (inebilizumab), already approved for other conditions, was approved for generalized MG on December 11, 2025, for adults who are AChR or MuSK antibody positive. Imaavy (nipocalimab), approved on April 29, 2025, is the newest medicine approved for generalized MG. Regeneron's cemdisiran has an FDA decision due in November 2026, and AstraZeneca's gefurulimab is under FDA review. The table on this page lists every approved drug with its trial results from the FDA label.
Which myasthenia gravis drugs can be taken at home?
Zilbrysq (zilucoplan) is a once-daily shot under the skin that patients give themselves. Vyvgart Hytrulo, the under-the-skin version of Vyvgart, can be self-injected once a week for 4 weeks per cycle. Rystiggo is also given under the skin but by a healthcare provider using a pump, and Soliris, Ultomiris, Uplizna and the IV form of Vyvgart are clinic infusions.
Which myasthenia gravis drugs have a boxed warning?
The 3 complement inhibitors, Soliris, Ultomiris and Zilbrysq, carry a boxed warning for serious meningococcal infections and require vaccination and enrollment in a safety program before the first dose. The FcRn blockers Vyvgart, Rystiggo and Imaavy, and the B-cell drug Uplizna, have no boxed warning; their main warnings are infections and infusion or hypersensitivity reactions.
Is Vyvgart better than Rystiggo?
No trial has compared them. In its own trial, 68% of AChR-positive patients on Vyvgart were MG-ADL responders in the first cycle against 30% on placebo. Rystiggo's trial reported a 2.6-point greater MG-ADL improvement than placebo at day 43. Vyvgart is given weekly for 4 weeks per cycle, Rystiggo for 6 weeks per cycle, and both repeat cycles on the doctor's judgment. Rystiggo's label also covers MuSK-positive disease; the current Vyvgart label covers generalized MG with no antibody qualifier.
Which myasthenia gravis treatment is given least often?
Uplizna, after 2 starting doses 2 weeks apart, is a clinic infusion once every 6 months. Ultomiris is every 8 weeks after a loading dose. The FcRn blockers run in cycles of weekly doses, Soliris and Imaavy are every 2 weeks, and Zilbrysq is daily.
More on Myasthenia Gravis at Trial Friend
Where every number on this page comes from
Approved-drug facts are from the current FDA prescribing information on DailyMed, with the label's effective date. Investigational-drug facts are from ClinicalTrials.gov and the sources named in each row.
- Soliris (eculizumab) prescribing information, Alexion (AstraZeneca), label dated Jul 2026. DailyMed. Pivotal trial: ClinicalTrials.gov
- Vyvgart (efgartigimod alfa-fcab) prescribing information, argenx, label dated May 2026. DailyMed. Pivotal trial: publication
- Rystiggo (rozanolixizumab-noli) prescribing information, UCB, label dated Jan 2026. DailyMed. Pivotal trial: publication
- Zilbrysq (zilucoplan) prescribing information, UCB, label dated Feb 2026. DailyMed. Pivotal trial: ClinicalTrials.gov
- Ultomiris (ravulizumab-cwvz) prescribing information, Alexion (AstraZeneca), label dated Oct 2025. DailyMed. Pivotal trial: ClinicalTrials.gov
- Uplizna (inebilizumab-cdon) prescribing information, Amgen, label dated Dec 2025. DailyMed. Pivotal trial: ClinicalTrials.gov
- Imaavy (nipocalimab-aahu) prescribing information, Johnson & Johnson, label dated Aug 2026. DailyMed. Pivotal trial: publication
This page compares what the FDA labels and pivotal trials report. It is not medical advice, and no trial on this page compared these drugs with each other. Written and checked by Jason Hunter; the method is on the editorial standards page.