Journal
NEUROLOGIC CLINICS
Volume 36, Issue 2, Pages 311-+Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.ncl.2018.01.011
Keywords
Myasthenia gravis; Pyridostigmine; Prednisone; Thymectomy; Immunotherapy; Complement inhibition; Intravenous immunoglobulin; Plasma exchange
Categories
Funding
- NIH
- FDA/OOPD
- NINDS
- Novartis
- Sanofi/Genzyme
- Biomarin
- IONIS
- Teva
- Cytokinetics
- Eli Lilly
- PCORI
- ALSA
- PTC
- CTSA grant from NCATS [UL1TR002366]
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With specialized care, patients with myasthenia gravis can have very good outcomes. The mainstays of treatment are acetylcholinesterase inhibitors and immunosuppressive and immunomodulatory therapies. There is good evidence that thymectomy is beneficial in thymomatous and nonthymomatous disease. Nearly all of the drugs used for MG are considered off-label. The 2 exceptions are acetylcholinesterase inhibitors and complement inhibition with eculizumab, which was recently approved by the US Food and Drug Administration for myasthenia gravis. This article reviews the evidence base and provides a framework for the treatment of myasthenia gravis, highlighting recent additions to the literature.
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