Oral salbutamol for symptomatic treatment in MuSK antibody-positive myasthenia gravis: a single-centre experience

Excerpt

Symptomatic treatment in muscle-specific kinase antibody positive myasthenia gravis (MuSK MG) can pose a challenge for the clinical neurologist. Animal models have demonstrated that the MuSK antibody results in defects in the function of pre-synaptic nerve terminals as well as the reduction in number of post-synaptic acetylcholine receptors [1]. Pyridostigmine often lacks efficacy in the MuSK MG cohort and patients may develop significant side-effects such as abdominal pain, muscle cramps, fasciculations and an increased secretion burden- resulting in deterioration in the control of their MG [2]. Pyridostigmine has been shown in animal models to potentiate anti-MuSK-induced reductions in post-synaptic acetylcholine receptor density and endplate potential amplitude [3]. …