Multicentric prognostic observational study on biomarker profile in immunotherapy-naïve patients with highly active generalized myasthenia gravis (PROGNO-MG): a study protocol

Neurological Research and Practice · Published 2026-05-12 · DOI 10.1186/s42466-026-00482-8

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Authors (25)

Felix Kohle, Franz Felix Konen, Ulrike Grittner, Daniel Schulze, Stefanie Glaubitz, Christopher Nelke, Christina B. Schroeter, Niklas Huntemann, Peter Trillenberg, Julian Großkreutz, Benedikt Schoser, Charlotte Schubert, Jana Zschüntzsch, Michael Schroeter, Tobias Hegelmaier, Thomas Skripuletz, Jörn Peter Sieb, Tobias Ruck, Sven Meuth, Heinz Wiendl, Christian Wolfgang Keller, Jan D. Lünemann, Sophie Lehnerer, Andreas Meisel, Frauke Stascheit

Abstract

Abstract Background Myasthenia gravis has a variable disease course. Early identification of patients with a highly active disease is crucial to prevent myasthenic exacerbations and crisis, necessitating more aggressive immunotherapy. However, no biomarkers currently exist to identify patients at risk for highly active disease course. Objective The PROGNO-MG study aims to identify blood-based biomarker signatures associated with a highly active disease course in immunotherapy-naïve patients with acetylcholine-receptor-antibody positive (AChR+) generalized Myasthenia gravis (gMG). Methods This is an investigator-initiated prospective, multicentric, observational study. Seventy newly diagnosed immunotherapy-naïve AChR+ gMG patients will be enrolled and followed up for 24 months. Blood samples and clinical data will be collected biannually. Biomarkers (calprotectin, neurofilament light chain, ITIH3, complement activation, kappa free light chains, and exploratory proteome-analyses and immune cell phenotyping) will be measured and their association with clinical outcomes will be evaluated. Perspective The results will provide evidence for prognostic biomarkers, supporting risk stratification and early individualized treatment for AChR+ gMG patients. Trial registration The study is registered in the German clinical trial register (DRKS00035457).

Abstract from DOAJ. Public domain (CC0 1.0).

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Publication details

Year
2026

Citation

Kohle, F., Konen, F., Grittner, U., et al. (2026). Multicentric prognostic observational study on biomarker profile in immunotherapy-naïve patients with highly active generalized myasthenia gravis (PROGNO-MG): a study protocol. Neurological Research and Practice. https://doi.org/10.1186/s42466-026-00482-8

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