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Article History

Received: 12 October 2025

Revised: 4 February 2026

Accepted: 8 February 2026

First Online: 25 February 2026

Declarations

:

: Hannah Preßler, Lisa Schwarz, Simon Streit, Alicia Schleicher, Friederike A. Arlt, Viktoria Zinnow, Tatjana Khorassani, Harald Prüß, Wolfgang Böhmerle, Werner Stenzel, and Franziska Scheibe have no competing interests to declare that are relevant to the content of this article. Frauke Stascheit received travel/accommodation/meeting expenses from Alexion Pharmaceuticals and argenx and received speaking honoria and honoria for attendance at advisory boards from Alexion Pharmaceuticals, argenx, and UCB pharma. She receives financial research support (paid to her institution) from Alexion Pharmaceuticals and Cytel. She serves as a member of the medical advisory of the German Myasthenia Gravis Society e.V. A.M. received speaker’s speaker or consultancy honoraria or financial research support (paid to his institution) from Alexion AstraZeneca Rare Disease, Amgen, argenx, Axunio, Desitin, Genpharm, Grifols, Hormosan, Immunovant, Johneson & Johnson, Merck, Novartis, Octapharma, Regeneron, Sanofi, and UCB. He serves as member (chairmen from 2019–2024) of the medical advisory board of the German Myasthenia Gravis Society.

: The study was approved by the institutional ethics committee of Charité–Universitätsmedizin Berlin, Germany (EA2/096/21, EA4/166/23) and was performed in accordance with the Declaration of Helsinki. Generative artificial intelligence (AI) was used to improve language clarity (Chat GPT-4; Open AI). Any use of generative AI in this manuscript adheres to ethical guidelines for use and acknowledgement of generative AI in academic research [ ]. This article follows the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guidelines.