Background Myasthenia gravis (MG) is an autoimmune neuromuscular disorder in which approximately 10–15% of patients with generalized AChR antibody–positive MG develop refractoriness to standard immunosuppressive therapies. Advanced therapeutic strategies, including FcRn antagonists and C5 complement inhibitors, have demonstrated early and sustained clinical efficacy in pivotal phase 3 trials. However, evidence supporting their early use in complex clinical scenarios remains limited. Case report