Update in immunosuppressive therapy of myasthenia gravis

Autoimmunity Reviews
Agustina M Lascano, Patrice H Lalive

Abstract

Myasthenia gravis (MG) is an autoimmune disease of the neuromuscular junction. Immunosuppressive treatments are part of the therapeutic armamentarium in MG. Long-term systemic steroid administration carry considerable risks and adverse events. Consequently, steroid-free immunosuppressive therapy is necessary to reduce the dose or discontinue steroids. First immunosuppressive drug trials in MG were performed in the mid-60s using standard and nonspecific immunosuppression. Since then, only few randomized controlled clinical trials were conducted in MG and assesed drug efficacy in terms of its steroid-sparing capacity and the ability to reduce myasthenic signs and symptoms. Treatment strategy in MG is quite challenging, mainly due to the disease heterogeneity in terms of clinical presentation, immunopathogenesis and drug response. To solve this dilemma, emerging treatment are based on biological drugs and use new targets of the immune pathway.

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Citations

Mar 17, 2021·Autoimmunity Reviews·Rui ZhaoChongbo Zhao
Jun 20, 2021·Lancet Neurology·Shigeaki Suzuki
Nov 11, 2021·American Journal of Therapeutics·Peter ManuCorina Roman-Filip

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