BIOOCUS Medical Group’s Dual CD19/BCMA CAR-T Therapy Delivers Promising Results in Refractory Myasthenia Gravis: A Young Patient’s Journey

Myasthenia Gravis (MG) is a chronic autoimmune neuromuscular disorder caused by autoantibodies (primarily anti-acetylcholine receptor antibodies, AchRAb) that impair nerve-muscle communication, leading to fluctuating weakness, ptosis, dysphagia, and in severe cases life-threatening respiratory failure. For patients with refractory MG who have not responded to conventional immunosuppressants, IVIG, FcRn inhibitors, or complement inhibitors, treatment options have been limited—until now.

BIOOCUS Medical Group’s dual-target CD19/BCMA CAR-T therapy represents a breakthrough autologous cell therapy that precisely eliminates pathogenic B cells and plasma cells responsible for autoantibody production. This dual-target approach offers the potential for deep and durable remission by addressing both the cellular and humoral components of the autoimmune response.

A representative case highlights the therapy’s promise. A 20-year-old female patient, referred to as LYN, was diagnosed with refractory Myasthenia Gravis (CNGIIIa, AchRAb-positive) and post-surgical B3-type thymoma/thymic hyperplasia. She also had comorbidities including osteoporosis, bilateral femoral head and left proximal tibial avascular necrosis, and iron-deficiency anemia. Despite multiple lines of therapy from 2019 to 2025—including high-dose steroids plus azathioprine, tacrolimus, cyclosporine, repeated IVIG, efgartigimod, eculizumab plus telitacicept, and rituximab (500 mg)—her condition remained uncontrolled.

In November 2025, the CAR-T protocol was initiated and cyclosporine was paused. Peripheral blood mononuclear cells were collected on December 1, 2025. On December 15, 2025, she received an infusion of CD19 CAR-T (0.5×10⁶/kg) plus BCMA CAR-T (1×10⁶/kg). No adverse events were observed post-infusion.

By March 2026, follow-up assessments showed rapid in-vivo CAR-T expansion, with peak CD19 CAR-T at day 10 (7.62%, 4.622×10⁷/L) and BCMA CAR-T at day 10 (17.17%, 1.0414×10⁸/L), sustained through month 3. Laboratory improvements included significant reduction in AchRAb levels and total B-lymphocyte counts, with stable blood counts, liver and kidney function. Clinically, notable gains were recorded in Quantitative Myasthenia Gravis (QMG) and Activities of Daily Living (ADL) scores. Symptoms such as diplopia, facial stiffness, dysarthria, and limb fatigue showed resolution or marked improvement.

This case demonstrates the transformative potential of BIOOCUS Medical Group’s dual-target CD19/BCMA CAR-T therapy in achieving deep immune reset and meaningful clinical benefit in refractory MG. The therapy is well-tolerated, with no CRS or neurotoxicity observed, and holds promise for long-term remission while reducing the need for chronic immunosuppression.