Neonatal Fc receptor (FcRn) blocker
Efgartigimod alfa
Brand names: Vyvgart
Adult dose
Dose: 10mg/kg IV once weekly for 4 weeks per cycle, repeat per response
Route: IV
Frequency: Weekly cycles, ≥6 weeks apart
Clinical pearls
- NICE TA935: anti-AChR antibody-positive generalised myasthenia gravis (Class II–IV) refractory to standard therapy
- ABN myasthenia guidance
- Specialist neurology centre; subcutaneous formulation (Vyvgart Hytrulo) emerging
Contraindications
- Active serious infection
- Hypersensitivity
Side effects
- Headache
- Infections (URTI, UTI)
- Infusion reactions
- Reduced IgG (expected)
Interactions
- Other monoclonal antibodies (theoretically reduced exposure due to FcRn blockade)
- Live vaccines
Monitoring
- IgG levels
- Infections
- MG-ADL / QMG scores
Reference: BNF; NICE TA935; ABN MG guidance; SmPC; https://bnf.nice.org.uk/drugs/efgartigimod-alfa/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- MAGGIC Heart Failure Risk Score · Heart Failure
- Long QT Syndrome (Schwartz Score) · Channelopathy / Sudden Cardiac Death
- Glucose Infusion Rate (GIR) Calculator · Glucose Management
- APGAR Score · Neonatal Assessment
- Hour-Specific Bilirubin Risk Assessment (Bhutani Nomogram) · Neonatal Jaundice
- Finnegan Neonatal Abstinence Scoring Tool (FNAST) · Neonatal Abstinence Syndrome
Pathways
- Acute Stroke / TIA Assessment · NICE NG128; RCP Stroke Guidelines 2023
- Status Epilepticus (Adults) · NICE CG137; ESEM guidelines; RCP Neurology Guidelines
- Suspected Subarachnoid Haemorrhage · NICE NG228; RCEM 2023; AHA/ASA 2023
- Adult Head Injury · NICE NG232 (2023)
- Bell's Palsy / Facial Nerve Palsy · ENT UK 2017; AAN
- Vertigo Workup · ENT UK; NICE CKS