Myasthenia gravis treatment approved for NHS use in Scotland
10 August 2026
Zilucoplan (Zilbrysq) has been accepted for NHS use in Scotland, becoming the first targeted treatment approved for refractory myasthenia gravis in the country. Following the approval of rozanolixizumab (Rystiggo) for NHS use in England earlier this year, there is now an approved targeted treatment option across the UK.
People living with myasthenia gravis can experience symptoms that make everyday activities difficult or impossible. New treatment options that could help have been developed, but for many people they have remained out of reach.
For years, we have worked alongside people living with myasthenia gravis, healthcare professionals and the charity myaware to push for access to these treatments. Together, we have highlighted both the reality of living with the condition and the need for decisions that better recognise the challenges faced by people with rare conditions.
Today’s decision marks a significant step forward. Earlier this year, rozanolixizumab (Rystiggo) was approved for NHS use in England, with recommendations typically extending across England, Wales and Northern Ireland. The approval of zilucoplan in Scotland means that, for the first time, an approved targeted treatment option for refractory myasthenia gravis will be available through NHS systems in every nation of the UK.
This success belongs to the community. It reflects the dedication of everyone who shared their experiences, spoke up about the challenges of living with myasthenia gravis and helped make the case for access to new treatment options.
What is myasthenia gravis?
Myasthenia gravis is a rare condition in which the immune system attacks the connection between nerves and muscles, causing muscle weakness, fatigue and difficulty with everyday activities.
Treatments such as steroids and immunosuppressants can help some people manage their symptoms. However, they do not work for everyone and can cause significant side effects. Targeted treatments such as zilucoplan and rozanolixizumab offer new options for people whose symptoms remain difficult to control.
Building on this progress
Today’s announcement is a landmark moment, but people living with myasthenia gravis still do not have access to the same range of treatments across the UK.
Zilucoplan has now been approved for NHS use in Scotland. However, the National Institute for Health and Care Excellence (NICE), which decides whether treatments should be routinely available on the NHS in England, has still not made a final decision on use despite reviewing it for three years.
Meanwhile, although rozanolixizumab is approved for NHS use in England, it has not yet been assessed by the Scottish Medicines Consortium (SMC) for use in Scotland. There is currently no timeline for this assessment.
“This approval is a significant milestone, and one that has only been possible because of the dedication of the myasthenia gravis community. While we celebrate this progress, we know people across the UK still do not have access to the same range of treatment options. With other promising treatments on the horizon, we will continue working alongside the community, healthcare professionals and our partners to ensure everyone can access the treatment that is right for them, regardless of where they live.”
Our Chief Executive, Andy Fletcher
How can I support?
One of the ways we can continue building on this progress is by helping to shape NICE’s decision on zilucoplan in England.
While NICE approved rozanolixizumab earlier this year, it still has questions about zilucoplan’s value for money. This is because the treatments work in different ways, are administered differently and are supported by different evidence.
NICE is now asking for feedback to help inform its next decision. We will be submitting comments alongside myaware and are particularly interested in hearing from people with experience of plasma exchange (PLEX). NICE is comparing zilucoplan with treatments already used for myasthenia gravis, including PLEX, and we want to ensure the realities of receiving this treatment are properly understood.
We are also keen to hear from people who have experience of zilucoplan. We want to understand the difference the treatment has made to your condition, particularly whether it has reduced exacerbations or myasthenic crises compared with previous treatments such as IVIg or PLEX.
If you have myasthenia gravis and have experience of PLEX, please complete our survey.
Anyone can also submit comments directly to NICE before the consultation closes on Friday 28 August. Details of how to respond can be found on the NICE website.
