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Current Treatment Options in Neurology
Published in: Current Treatment Options in Neurology 8/2020

01-08-2020 | Myasthenia Gravis | Neuromuscular Disorders (C Fournier, Section Editor)

Myasthenia Gravis Treatment Updates

Authors: Elena Cortés-Vicente, MD, PhD, Eduard Gallardo, PhD, Rodrigo Álvarez-Velasco, MD, Isabel Illa, MD, PhD

Published in: Current Treatment Options in Neurology | Issue 8/2020

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Abstract

Purpose of review

This review presents an update of current treatment strategies for patients with myasthenia gravis (MG) depending on their clinical and immunological characteristics.

Recent findings

Nowadays, the available treatment options for MG are: (1) inhibitors of the acetylcholinesterase, useful as symptomatic treatment; (2) immunosuppressive drugs, the main treatment, initiated and escalated following international guidelines; (3) immunomodulatory drugs (intravenous immunoglobulin and plasma exchange), predominantly used in acute worsening or MG crisis; and (4) thymectomy, performed in patients with thymoma, and also in patients younger than 65 years with anti-acetylcholine receptor antibodies and no thymoma, following the recommendations of a recent international clinical trial. MG is a heterogeneous disease, so the selection of treatments depends on the characteristics of the patient, being especially important, their immunological profile. For instance, anti-MuSK positive patients respond extraordinarily to rituximab. Recently approved drugs, such as eculizumab and subcutaneous immunoglobulin, and ongoing clinical trials are discussed.

Summary

The prognosis of MG patients has improved remarkably due to a better understanding of the heterogeneity of the disease and the appearance of new therapeutic options and approaches. However, side effects are not infrequent and around 10% of patients are refractory to conventional treatments, showing the need to develop new and more specific drugs.
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Metadata
Title
Myasthenia Gravis Treatment Updates
Authors
Elena Cortés-Vicente, MD, PhD
Eduard Gallardo, PhD
Rodrigo Álvarez-Velasco, MD
Isabel Illa, MD, PhD
Publication date
01-08-2020
Publisher
Springer US
Published in
Current Treatment Options in Neurology / Issue 8/2020
Print ISSN: 1092-8480
Electronic ISSN: 1534-3138
DOI
https://doi.org/10.1007/s11940-020-00632-6