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- | (1/3) Subclinical myasthenia gravis in thymomas. (Twitter) - Dec 25, 2020
- || Clinical, Journal: Improvement in symptom remission rate following robotic thymectomy in patients with myasthenia gravis. (Pubmed Central) - Dec 23, 2020
Patients who underwent RATS thymectomy and were younger or medically remitted before surgery were more likely to achieve CSR. Both methods yield excellent perioperative outcome.
- || Zilbrysq (zilucoplan) / UCB
Trial completion: Safety and Efficacy Study of RA101495 in Subjects With Generalized Myasthenia Gravis (clinicaltrials.gov) - Dec 23, 2020
P2, N=44, Completed, Sponsor: Ra Pharmaceuticals
Both methods yield excellent perioperative outcome. Active, not recruiting --> Completed
- | Journal: AChR antibodies show a complex interaction with human skeletal muscle cells in a transcriptomic study. (Pubmed Central) - Dec 23, 2020
Furthermore, we found changes in a protein-coding RNA and lncRNA network, where expression of lncRNA MEG3 correlated closely with protein-coding genes for cellular homeostasis. We conclude that AChR antibodies induce an active response in human skeletal muscle cells which affects key intra- and extracellular pathways.
- | prednisone / Generic mfg.
Journal: Intravenous immunoglobulins may prevent prednisone-exacerbation in myasthenia gravis. (Pubmed Central) - Dec 22, 2020
We conclude that adjuvant therapy with IVIG when starting prednisone for the first time in patients with generalized MG is safe and effective. Given that the rate of paradoxical worsening was lower than that previously reported, the addition of IVIG may have a protective effect against such exacerbations.
- || Opdivo (nivolumab) / Ono Pharma, BMS
Clinical, Journal: Advanced Gastric Cancer with Tumor Shrinkage Persisting after the Discontinuation of Nivolumab-A Case Report (Pubmed Central) - Dec 22, 2020
The patient is being followed-up as an outpatient. Here, we reported a case of gastric cancer with tumor shrinkage after the discontinuation of NIV.
- || Review, Journal: The Neuromuscular Junction in Health and Disease: Molecular Mechanisms Governing Synaptic Formation and Homeostasis. (Pubmed Central) - Dec 22, 2020
There are also changes in NMJ structure and function in motor neuron disease, spinal muscle atrophy and sarcopenia that are likely to be secondary but might provide treatment targets. The NMJ is one of the best studied and most disease-prone synapses in the nervous system and it is amenable to in vivo and ex vivo investigation and to systemic therapies that can help restore normal function.
- | New trial: Clinical Trial Comparing Two Non-Surgical Treatments for Severe Blepharoptosis (clinicaltrials.gov) - Dec 20, 2020
P=N/A, N=50, Not yet recruiting, Sponsor: Massachusetts Eye and Ear Infirmary
- | Journal: Paraneoplastic Cerebellar Degeneration and Lambert-Eaton Myasthenic Syndrome with SOX-1 Antibodies. (Pubmed Central) - Dec 19, 2020
Small-cell lung carcinoma (SCLC), which had not been obvious on computed tomography, was found during the autopsy. Patients with PCD-LEMS who test positive for SOX-1 antibodies should be carefully evaluated for SCLC.
- || Soliris (eculizumab) / Alexion Pharma
Clinical, Journal: Concomitant Immunosuppressive Therapy Use in Eculizumab-Treated Adults With Generalized Myasthenia Gravis During the REGAIN Open-Label Extension Study. (Pubmed Central) - Dec 19, 2020
P3
Clinical improvements with eculizumab were maintained by patients in all groups, including those who decreased and/or stopped concomitant ISTs. Trial registration: www.clinicaltrials.gov: NCT01997229, NCT02301624.
- | Journal: Neuromuscular Diseases Care in the Era of COVID-19. (Pubmed Central) - Dec 19, 2020
Lastly, the global COVID-19 situation will also have an economic impact on patients and their families. This situation is of particular concern given that neuromuscular diseases already present difficulties due to the scarcity of resources in terms of public healthcare and research.
- || Review, Journal: Myasthenia Gravis: Autoantibody Specificities and Their Role in MG Management. (Pubmed Central) - Dec 19, 2020
In this review, we will present the progress made toward the development of novel sensitive autoantibody detection assays, the identification of new MG autoantigens, and the implications for improved antigen-specific therapeutics. These advancements increase our understanding of MG pathology and improve patient quality of life by providing faster, more accurate diagnosis and better disease management.
- || Review, Journal: Controversies in Ocular Myasthenia Gravis. (Pubmed Central) - Dec 19, 2020
Prolonged exposure to immunosuppressive therapy has a negative impact on the health-related quality of life in a proportion of these patients. OMG is currently excluded from most of the treatments recently developed in generalized MG.
- || Biomarker, Clinical, Journal: Myasthenia Gravis Is Not an Independent Prognostic Factor of Thymoma: Results of a Propensity Score Matching Trial of 470 Patients. (Pubmed Central) - Dec 19, 2020
No differences were found in the progression-free survival, distant metastasis-free survival, and local-regional relapse-free survival between the two groups. MG is not an independent or direct prognostic factor of thymoma, although it might be helpful in diagnosis thymoma at an early stage, leading indirectly to better prognosis.
- ||| Clinical: Definitely. I saw a patient recently who was a man, but had myasthenia gravis. I thought that was unusual.Nowhere in the chart did it say he was born a female.I asked him and he told me he was transsexual. Important information, for sure. Patients don’t tell you if you don’t ask. (Twitter) - Dec 19, 2020
- | New trial: A Prospective Cohort Study Of Myasthenia Gravis (clinicaltrials.gov) - Dec 19, 2020
P, N=200, Recruiting, Sponsor: First Affiliated Hospital of Chongqing Medical University
- | Preclinical, Journal: miR-1933-3p is upregulated in skeletal muscles of MuSK+ EAMG mice and affects Impa1 and Mrpl27. (Pubmed Central) - Dec 19, 2020
Further, transient expression of miR-1933-3p reduced Impa1 protein accumulation in C2C12 cells. These findings provide novel insights of dysregulated miRNAs and their intracellular pathways in muscle tissue afflicted with MuSK + EAMG, providing a possible link to mitochondrial dysfunction and muscle atrophy observed in MuSK + MG.
- | Retrospective data, Journal: Therapeutic Plasma Exchange in Tehran Blood Transfusion Between 2011 and 2014. (Pubmed Central) - Dec 19, 2020
These findings provide novel insights of dysregulated miRNAs and their intracellular pathways in muscle tissue afflicted with MuSK + EAMG, providing a possible link to mitochondrial dysfunction and muscle atrophy observed in MuSK + MG. We observed that the most prevalent illnesses are respectively neurologic (Myasthenia Gravis), Hematologic (TTP) and renal.
- | Review, Journal: Plasma exchange in neurological disease. (Pubmed Central) - Dec 19, 2020
The recent recognition of rapidly progressive severe antibody-mediated central nervous system disorders, such as neuromyelitis optica spectrum disorders and anti-N-methyl-D-aspartate-receptor encephalitis, has renewed interest in using plasma exchange for their acute treatment also. In this review we explain the principles and technical aspects of plasma exchange, review its current indications, and discuss the implications for its provision in the UK.
- | Journal: Diffuse large B cell lymphoma mimics myasthenia gravis. (Pubmed Central) - Dec 18, 2020
In this review we explain the principles and technical aspects of plasma exchange, review its current indications, and discuss the implications for its provision in the UK. No abstract available
- | Journal: Thymoma and pure red cell aplasia with hypoplasia of megakaryocytopoiesis: A rare and life-treating condition. (Pubmed Central) - Dec 18, 2020
Considering that there are no standard treatments, clinical condition improvement was achieved only after some lines of medical treatment. Our data, together with the few already published, help to raise the attention towards acquired cytopenias and the need to optimize the treatment for a potentially life-threatening condition.
- || Review, Journal: MUSK FUNCTION DURING HEALTH AND DISEASE. (Pubmed Central) - Dec 18, 2020
Conclusions about the regulation of the MuSK kinase that were derived from molecular structures will be highlighted. In addition, the role of MuSK during development and disease will be discussed.
- | Journal: Predictive Features of Thymic Carcinoma and High-Risk Thymomas Using Random Forest Analysis. (Pubmed Central) - Dec 18, 2020
Tumor shape, lymphadenopathy, and pericardial effusion are the key features for tumor differentiation. Thymic tumors with irregular shape, the presence of lymphadenopathy, and pericardial effusion are highly indicative of thymic carcinomas.
- | Journal: Effect of Grilled Nux Vomica on Differential RNA Expression Profile of Gastrocnemius Muscle and Toll‑Like Receptor 4 (TLR-4)/Nuclear Factor kappa B (NF-κB) Signaling in Experimental Autoimmune Myasthenia Gravis Rats. (Pubmed Central) - Dec 18, 2020
GNV treatment also significantly reduced the TLR-4 and NF-kappaB p65 protein expression in EAMG rats. CONCLUSIONS These results indicate that grilled nux vomica ameliorates EAMG by depressing the TLR-4/NF-kappaB signaling pathway, and hub genes may serve as potential targets for MG treatment.
- || Clinical, Journal: Lung cancer prediction in Lambert-Eaton myasthenic syndrome in a prospective cohort. (Pubmed Central) - Dec 18, 2020
The area under the curve of the receiver operating curve was 82.5% (95% CI 73.9% to 91%). The DELTA-P cancer prediction score, calculated at the time of LEMS diagnosis, is an effective tool for cancer screening in an independent, prospective study setting.
- | Journal: Improving accuracy of myasthenia gravis autoantibody testing by reflex algorithm. (Pubmed Central) - Dec 18, 2020
STR and other reflexed cancer evaluation autoantibodies did not provide value beyond standard CT-chest imaging at the time of MG diagnosis. Diagnostic certainty is informed by AChR-Bi and AChR-Mo with higher values increasing specificity.
- || Biomarker, Clinical, Journal, IO Biomarker: The treatment effect on peripheral B cell markers in antibody positive myasthenia gravis patients. (Pubmed Central) - Dec 18, 2020
Serum levels of BAFF were elevated in untreated MG patients as compared to treated MG patients and healthy controls. B cell activation factors may show profound alterations due to immunosuppression.
- | Journal: Modulation of immune responses by bile acid receptor agonists in myasthenia gravis. (Pubmed Central) - Dec 18, 2020
In contrast, TGR5 and FXRα agonists elicit distinct B cell responses in myasthenia compared to controls, specifically on the frequency of IL-6 B cells and regulatory B cells, as well as IL-10 secretion from PBMCs. We propose that TGR5 is a potential therapeutic target in myasthenia.
- || prednisone / Generic mfg.
Biomarker, Clinical, Journal: Comparison of anti-acetylcholine receptor profiles between Chinese cases of adult- and juvenile-onset myasthenia gravis using cell-based assays. (Pubmed Central) - Dec 18, 2020
The positive rates of AChR antibodies did not differ between Chinese AOMG and JOMG patients, as revealed by CBAs. Furthermore, the screened AChR antibodies were predominantly IgG1 in both AOMG and JOMG patients.
- | Soliris (eculizumab) / Alexion Pharma
Journal: Severe worsening of myasthenic symptoms after the eculizumab discontinuation. (Pubmed Central) - Dec 18, 2020
This is an informative case because eculizumab discontinuation in patients with MG has been very rarely reported. If eculizumab treatment is clinically well effective and AChR antibody titer does not decrease, clinicians should be aware that acute and critical deterioration of MG may occur after the eculizumab discontinuation.
- || Clinical, Journal: Peak expiratory flow and the single-breath counting test as markers of respiratory function in patients with myasthenia gravis. (Pubmed Central) - Dec 17, 2020
If eculizumab treatment is clinically well effective and AChR antibody titer does not decrease, clinicians should be aware that acute and critical deterioration of MG may occur after the eculizumab discontinuation. PEF, the single-breath counting test, and the mMRC scale are useful measures for evaluating respiratory function in patients with MG.
- | Journal: Outcome measures and treatment effectiveness in late onset myasthenia gravis. (Pubmed Central) - Dec 17, 2020
Despite LOMG has more comorbidities that might interfere with treatment and outcome, therapeutic management does not seem to differ between EOMG and LOMG. A similar positive outcome was seen in both subgroups but LOMG group seems to require lower doses of medication to control symptoms.
- | Bavencio (avelumab) / EMD Serono, Pfizer
Journal, Checkpoint inhibition: Immunoglobulins to mitigate paraneoplastic Lambert Eaton Myasthenic Syndrome under checkpoint inhibition in Merkel cell carcinoma. (Pubmed Central) - Dec 17, 2020
This is the first description of paraneoplastic LEMS, avelumab, and Merkel cell carcinoma. We conclude that immunoglobulins are an option to control an ICI-associated deterioration of paraneoplastic symptoms.
- || Clinical, Journal: Interleukin-27 levels in patients with myasthenia gravis. (Pubmed Central) - Dec 17, 2020
IL-27 may participate in the pathogenesis of MG and can be used as an early marker for the diagnosis and prognosis of MG. In addition, IL-27 can be used as a target for MG treatment through the regulation of specific immune signaling and maintaining immune homeostasis.
- [VIRTUAL] The Collision of Good Syndrome and Autoimmunity in Thymic Epithelial Tumors (Scientific Program Auditorium) - Dec 17, 2020 - Abstract #IASLCWCLC2020IASLC_WCLC_1832;
In case of coexisting AD, taking into account the grater reduction of CD19+ B cells, the physician should be careful in the management of immunosuppressive therapy for both AD and TET diagnosis. The multidisciplinary approach is mandatory.
- KN046 / Alphamab
[VIRTUAL] Preliminary Safety, Efficacy Results of KN046 (Bispecific Anti-PD-L1/CTLA4) in Subjects With Rare Thoracic Tumors (Scientific Program Auditorium) - Dec 17, 2020 - Abstract #IASLCWCLC2020IASLC_WCLC_1830;
KN046 demonstrated preliminary but promising efficacy in thymic epithelial tumors. Follow on study in thymic carcinoma is planned.
- [VIRTUAL] Is Thymomectomy alone through Video-Assisted Thoracic Surgery Appropriate for Clinical Stage I (T1N0M0) Thymoma 5cm or Less? (ePoster Hall) - Dec 17, 2020 - Abstract #IASLCWCLC2020IASLC_WCLC_801;
For nonmyasthenic patients with thymoma, removal of all normal thymus might be unnecessary. Further studies are needed to evaluate long-term outcomes.
- [VIRTUAL] Postoperative Course of Thymoma with Myasthenia Gravis. (ePoster Hall) - Dec 17, 2020 - Abstract #IASLCWCLC2020IASLC_WCLC_800;
Conclusion For myasthenia gravis, it was considered difficult to improve the symptoms by surgery alone. It was suggested that surgical stress may be involved in the onset of crisis immediately after surgery.
- [VIRTUAL] Video-Assisted Thoracoscopic Surgery for Stage I Thymoma: Short-Term Outcomes and Appropriate Indications (ePoster Hall) - Dec 17, 2020 - Abstract #IASLCWCLC2020IASLC_WCLC_799;
In VATS group, 21 patients were followed longer than 5 years, no one had recurrence nor mortality. Conclusion The VATS approach has been safely performed for a small (radiological size ≤3cm) c-stage I thymoma and the short-term outcomes were acceptable.
- [VIRTUAL] Minimally Invasive Thymectomy For Myasthenia Gravis: An Over 6-Year Retrospective Study () - Dec 17, 2020 - Abstract #IASLCWCLC2020IASLC_WCLC_792;
Conclusion The VATS approach has been safely performed for a small (radiological size ≤3cm) c-stage I thymoma and the short-term outcomes were acceptable. The abstract for this presentation is currently under embargo or has not been submitted.
- [VIRTUAL] Outcomes of Resected Thymic Epithelial Tumors (TET), insights from RYTHMIC (ePoster Hall) - Dec 17, 2020 - Abstract #IASLCWCLC2020IASLC_WCLC_291;
Thymic carcinoma and thymoma B3 were more likely to progress. Pleura was the main site for recurrence and surgery the most used treatment, in addition with intrapleural chemotherapy in some cases.
- | Journal: Defects of CTLA-4 Are Associated with Regulatory T Cells in Myasthenia Gravis Implicated by Intravenous Immunoglobulin Therapy. (Pubmed Central) - Dec 17, 2020
Interestingly, IVIg therapy significantly reduced the methylation level at these two sites in MG patients. Overall, our study may suggest a role of CTLA-4 in functionally defected Treg cells in MG and its actions involved in IVIg therapy.
- | Journal: Myasthaenia gravis in pregnancy, delivery and newborn. (Pubmed Central) - Dec 17, 2020
Most of the myasthenic women could have uneventful pregnancy with good obstetrical outcomes, both for mother and neonate. However, a careful planning of pregnancy and multidisciplinary team approach, composed by neurologists, obstetricians, neonatologists and anesthesiologists, is required to manage these pregnancies.
- || Clinical, Review, Journal: Peripheral B Cell Subsets in Autoimmune Diseases: Clinical Implications and Effects of B Cell-Targeted Therapies. (Pubmed Central) - Dec 17, 2020
An improved understanding of subgroups may also enhance the knowledge of antigen-specific B cell differentiation. We further discuss the influence of current B cell therapies on B cell subsets, specifically focusing on systemic lupus erythematosus, rheumatoid arthritis, and myasthenia gravis.
- | Retrospective data, Journal: Adult Ocular Myasthenia Gravis Conversion: A Single-Center Retrospective Analysis in China. (Pubmed Central) - Dec 16, 2020
The conversion of adult OMG was associated with anti-AChR Ab titer, onset age, and bilateral ptosis. The estimated conversion rate of Chinese adult OMG patients was 70%.
- | Journal: Myasthenic crisis in the setting of Coronavirus Disease 2019 (COVID-19). (Pubmed Central) - Dec 16, 2020
The estimated conversion rate of Chinese adult OMG patients was 70%. No abstract available
- || Clinical, Journal: Comparison of ice-pack test and single fiber EMG diagnostic accuracy in patients referred for myasthenic ptosis. (Pubmed Central) - Dec 16, 2020
IPT and SF-EMG have a similar diagnostic accuracy in patients with OM presenting with ptosis. The negativity of both tests strongly suggests another diagnosis.
- || Review, Journal: Update on IgG4-mediated autoimmune diseases: New insights and new family members. (Pubmed Central) - Dec 16, 2020
Interestingly, IgG4 autoimmune diseases are restricted to four distinct organs: 1) the central and peripheral nervous system, 2) the kidney, 3) the skin and mucous membranes and 4) the vascular system and soluble antigens in the blood circulation. The pathogenicity of IgG4 can be validated using our classification system, and is usually excerted by functional blocking of protein-protein interaction.
- | Journal: Myasthenic crisis due to anxiety and insomnia during COVID -19 pandemic. (Pubmed Central) - Dec 16, 2020
The pathogenicity of IgG4 can be validated using our classification system, and is usually excerted by functional blocking of protein-protein interaction. No abstract available