Myasthenia gravis treatment approved for NHS use in England

29 April 2026

The approval of rozanolixizumab (Rystiggo) for NHS use in England makes it the first approved treatment designed specifically for myasthenia gravis – a major breakthrough, and an important step towards greater treatment choice.

Over the past couple of years, we have been working alongside people living with myasthenia gravis, clinicians and the charity myaware, to call for better access to treatments that could make a real difference to daily life. Until now, several treatments assessed by NICE have been rejected, despite being described as life-changing by people living with myasthenia gravis.

That has now changed. NICE has recommended rozanolixizumab, meaning it will become available on the NHS in England. This decision would not have been possible without the involvement of people living with myasthenia gravis, who shared their experiences and explained what the right treatment can mean – not just medically, but for independence, work, family life and wellbeing.

What is myasthenia gravis?

Myasthenia gravis is a rare condition in which the immune system attacks the point where nerves and muscles communicate. As a result, messages from the brain do not reach muscles properly, causing muscle weakness, fatigue and difficulty with everyday activities. Many people find they have to give up things they enjoy, reduce or stop work, or plan each day carefully just to manage their symptoms.

Initial treatments often include steroids or other immunosuppressants. While these can help some people, they do not work for everyone and can come with significant side effects. Targeted treatments like rozanolixizumab offer a new option for people whose symptoms remain difficult to control.

Why this decision matters

Rozanolixizumab is approved for people with generalised myasthenia gravis who have acetylcholine receptor (AChR) or MuSK antibodies. It is the third targeted treatment for myasthenia gravis to be assessed by NICE. Previously, other treatments – including efgartigimod and zilucoplan – were not recommended, leaving people with myasthenia gravis without access to new, targeted options.

Earlier this year, we successfully appealed NICE’s decision on zilucoplan. As part of that appeal, the panel agreed it was unreasonable to exclude Minimal Symptom Expression (MSE) from its decision making. MSE describes a point where someone has no or very few symptoms – an outcome many people living with myasthenia gravis have told us is truly life changing.

Following that appeal outcome, the NICE committee assessing rozanolixizumab changed how MSE was considered in its decision, giving it proper importance as an outcome that matters to people with myasthenia gravis. We are delighted that this better reflects patient experience, and that it helped NICE reach a positive decision.

What does this mean for the rest of the UK?

Wales and Northern Ireland usually follow NICE recommendations. Decisions in Scotland are made separately by the Scottish Medicines Consortium (SMC), and next steps are still to be confirmed. We’ll continue working with partners across the UK and will keep the community updated as we hear more.

A milestone – but not the end

While today’s announcement is a landmark moment, there is still more to do. Not everyone responds to treatment in the same way, and some people may benefit more from other targeted therapies that are still not available on the NHS.

Everyone living with a muscle wasting or weakening condition deserves choice – access to the right treatment for them, at the right time. We will continue working with the myasthenia gravis community, clinicians and decision makers until all effective treatments are available, and no one is left behind.