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Article History

Received: 16 May 2025

Revised: 5 September 2025

Accepted: 6 September 2025

First Online: 19 September 2025

Declarations

:

: F.S. received travel/accommodation/meeting expenses from Alexion Pharmaceuticals and argenx and received speaking honoraria and honoraria for advisory boards from Alexion Pharmaceuticals, argenx and UCB Pharma. She receives financial research support (paid to her institution) from Alexion Pharmaceuticals and argenx. She serves as a member of the medical advisory of the German Myasthenia Gravis Society e.V. KH received financial reimbursement for consulting, advisory board activities, speaker fees and/or contributions to congresses and travel support to attend scientific meetings by Akcea Therapeuticals Inc., Alnylam Pharmaceuticals Inc., Amicus, AstraZeneca, GSK, Hormosan, Takeda Pharmaceutical Inc., Pfizer Pharmaceuticals Inc., Swedish Orphan Biovitrum Inc. and ViiV. KH further received research funding by the foundation Charité (BIH clinical fellow, digital accelerator), Alnylam Pharmaceuticals Inc., and Pfizer Pharmaceuticals. None of this were related to this project. T.R. reports grants from the German Ministry of Education, Science, Research and Technology, grants and personal fees from Sanofi, Alexion and argenx, personal fees from Roche and Merck outside the submitted work. A.M. received speaker or consultancy honoraria or financial research support (paid to his institution) from Alexion Pharmaceuticals, argenx, Axunio, Destin, Grifols, Hormosan Pharma, Janssen, Merck, Octapharma, UCB, and Xcenda. He serves as medical advisory board chairman of the German Myasthenia Gravis Society. C.P. received travel/accommodation/meeting expenses from Janssen Pharmaceutica NV, a Johnson and Johnson company and received speaking honoraria from argenx. BS received travel expenses and speaker honoraria from Alexion, argenx, and Johnson and Johnson. The remaining authors report no conflict of interest.

: Ethical approval was granted by the ethics committee of Charité-Universitätsmedizin Berlin (EA4/166/23). The patients provided their written informed consent to participate in this study according to the Declaration of Helsinki. This article follows the Strengthening the Reporting of Observational Studies in Epidemiology reporting guidelines [].