Myasthenia Gravis
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  • ||||||||||  Journal:  Myasthenic crisis in COVID-19. (Pubmed Central) -  Jun 25, 2020   
    The clinical significance of these changes needs to be investigated by further studies using rigorous designs and longer follow-up times. No abstract available
  • ||||||||||  Rystiggo (rozanolixizumab-noli) / UCB
    Enrollment open, Trial completion date, Trial primary completion date:  A Study to Test Efficacy and Safety of Rozanolixizumab in Adult Patients With Generalized Myasthenia Gravis (clinicaltrials.gov) -  Jun 22, 2020   
    P3,  N=240, Recruiting, 
    The mTOR-HIF-1α signaling pathway might be the immunometabolism reprogramming checkpoint of glycolysis-dependent activated B cells in MG. Suspended --> Recruiting | Trial completion date: Mar 2021 --> Sep 2021 | Trial primary completion date: Jan 2021 --> Jul 2021
  • ||||||||||  levetiracetam / Generic mfg.
    Contraindications to Magnesium Sulfate and Alternative Seizure Prophylaxis for Severe Preeclampsia () -  Jun 20, 2020 - Abstract #ACOG2020ACOG_827;    
    Levetiracetam, an alternative antiepileptic drug considered safe in pregnancy, has been suggested in such cases though its efficacy remains uncertain... The use of alternative anticonvulsant medications in preeclampsia, which may be less efficacious, must be reserved for true contraindications to magnesium sulfate.
  • ||||||||||  Preclinical, Journal:  Cognitive dysfunction in mice with passively induced MuSK antibody seropositive myasthenia gravis. (Pubmed Central) -  Jun 19, 2020   
    In the BM test, control mice were more eager to use the direct strategy than the MuSK+ mice (MuSK+ 17.3% vs controls 29.5%, p = .02). Our findings shed new light on cognition dysfunction in human MuSK+ MG patients and indicate that recognition memory in the perirhinal cortex could be affected in MuSK+ MG.
  • ||||||||||  Preclinical, Journal, Diagnostic Assay:  A novel MuSK cell-based myasthenia gravis diagnostic assay. (Pubmed Central) -  Jun 19, 2020   
    We found 46 (18.3%) MuSK-CBA Ab positive cases among 251 AChR-Ab negative cases [patients] and 4 (0.6%) MuSK-CBA Ab positive cases [among] the 624 AChR-Ab positive samples. Comparing these with available clinic assays, our highly specific CBA method is more sensitive than commercial ELISA and IFA(indirect immunofluorescence assay).
  • ||||||||||  Soliris (eculizumab) / Alexion Pharma, Rituxan (rituximab) / Roche, Biogen, Zenyaku Kogyo
    Review, Journal:  Myasthenia gravis: State of the art and new therapeutic strategies. (Pubmed Central) -  Jun 19, 2020   
    Many breakthroughs in the discovery of new therapeutic targets have been reported, but MG remains to be a chronic disease where the symptoms are kept in the majority of patients. In this review, we discuss the different therapeutic strategies that have been used over the years to alleviate MG symptoms, as well as innovative therapeutic approaches currently under study.
  • ||||||||||  Review, Journal:  Disorders of FZ-CRD; insights towards FZ-CRD folding and therapeutic landscape. (Pubmed Central) -  Jun 19, 2020   
    Current treatment strategies in-place for the conformational disease landscape is highlighted. From this review, we envision that disorders of FZ-CRD might be receptive to therapies that target FZ-CRD misfolding, regulation of fatty acids, and/or ER therapies; thus paving the way for a newly explored paradigm to treat different diseases with common defects.
  • ||||||||||  Clinical, Journal:  COVID-19 in Refractory Myasthenia Gravis- A Case Report of Successful Outcome. (Pubmed Central) -  Jun 19, 2020   
    She was quarantined for total of 14 days and recovered successfully without any complications (no myasthenia exacerbation or crisis, no COVID-19 related complications), with no changes to her immunosuppressive therapy. Treatment of MG patients with COVID-19 needs to be tailored to individual patient.
  • ||||||||||  clarithromycin / Generic mfg., azithromycin / Generic mfg.
    Clinical, Journal:  Proactive Prophylaxis With Azithromycin and HydroxyChloroquine in Hospitalised Patients With COVID-19 (ProPAC-COVID): A structured summary of a study protocol for a randomised controlled trial. (Pubmed Central) -  Jun 19, 2020   
    P2
    For atrial fibrillation/flutter, select according to the Cardiovascular National Treatment Guide (NBV): Calcium antagonist, Beta blocker, direct current (DC) conversion or amiodarone...Immediately after randomisation to the intervention group, the patient will begin treatment with: Azithromycin: Day 1-3: 500 mg x 1 Day 4-15: 250 mg x 1 If the patient is unable to take the medication orally by themselves, the medication will, if possible, be administered by either stomach-feeding tube, or alternatively, temporary be changed to clarithromycin 500 mg x 2 (this only in agreement with either study coordinator Pradeesh Sivapalan or principal investigator Jens-Ulrik Stæhr Jensen)...In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol. The study protocol has been reported in accordance with the Standard Protocol Items: Recommendations for Clinical Interventional Trials (SPIRIT) guidelines (Additional file 2).
  • ||||||||||  Firdapse (amifampridine) / BioMarin, Catalyst Pharma
    Journal:  Amifampridine for the treatment of Lambert-Eaton myasthenic syndrome. (Pubmed Central) -  Jun 18, 2020   
    AFPs are also the drug of choice and life-saving for LEMS crisis. For the long-term usage, it is proven to be safe and AFPs can be supplemented with liberal amount of pyridostigmine to sustain a symptomatic improvement without any undue side-reaction.
  • ||||||||||  ondansetron/pyridostigmine (DAS-001) / DAS Therap
    Trial completion date, Trial initiation date, Trial primary completion date:  Study of Pyridostigmine With Ondansetron in Subjects With Anti-AchR Positive Myasthenia Gravis (clinicaltrials.gov) -  Jun 15, 2020   
    P2,  N=24, Not yet recruiting, 
    For the long-term usage, it is proven to be safe and AFPs can be supplemented with liberal amount of pyridostigmine to sustain a symptomatic improvement without any undue side-reaction. Trial completion date: Apr 2021 --> Sep 2021 | Initiation date: Apr 2020 --> Sep 2020 | Trial primary completion date: Apr 2021 --> Sep 2021
  • ||||||||||  Circadin (melatonin prolonged release) / Lundbeck, Teva, Neurim, clarithromycin / Generic mfg.
    Clinical, Journal:  A randomized multicenter clinical trial to evaluate the efficacy of melatonin in the prophylaxis of SARS-CoV-2 infection in high-risk contacts (MeCOVID Trial): A structured summary of a study protocol for a randomised controlled trial. (Pubmed Central) -  Jun 11, 2020   
    P2/3
    HIV infection.Active hepatitis B infection.Renal failure (CrCl < 60 mL/min/1.73 m2) or need for hemodialysis.Osteoporosis.Myasthenia gravis.Pre-existent maculopathy.Retinitis pigmentosa.Bradycardia (less than 50 bpm).Weight less than 40 Kg.Participant with any immunosuppressive condition or hematological disease.Treatment with drugs that may prolong QT in the last month before randomization for more than 7 days including: azithromycin, chlorpromazine, cisapride, clarithromycin, domperidone, droperidol, erythromycin, halofantrine, haloperidol, lumefantrine, mefloquine, methadone, pentamidine, procainamide, quinidine, quinine, sotalol, sparfloxacin, thioridazine, amiodarone.Hereditary intolerance to galactose, Lapp lactase deficiency or glucose or galactose malabsorption.Treatment with fluvoxamine.Treatment with benzodiazepines or benzodiazepine analogues such as zolpidem, zopiclone or zaleplon.Pregnancy.Breastfeeding.History of potentially immune derived diseases such as: lupus, Crohn's disease, ulcerative colitis, vasculitis or rheumatoid arthritis.Insulin-dependent diabetes mellitus.Known history of hypersensitivity to the study drug or any of its components.Patients that should not be included in the study at the judgment of the research team...Experimental: Melatonin (Circadin®, Exeltis Healthcare, Spain): 2 mg of melatonin orally before bedtime for 12 weeks...EU Clinical Trials Register: 2020-001530-35; Date of trial registration: 13th of April 2020; https://www.clinicaltrialsregister.eu/ctr-search/trial/2020-001530-35/ES FULL PROTOCOL: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.
  • ||||||||||  Thymoglobulin (anti-thymocyte globulin (rabbit)) / Sanofi
    Enrollment open:  Autologous Stem Cell Transplant for Neurologic Autoimmune Diseases (clinicaltrials.gov) -  Jun 11, 2020   
    P2,  N=40, Recruiting, 
    In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol. Suspended --> Recruiting
  • ||||||||||  Review, Journal:  Emerging Roles of Dysregulated MicroRNAs in Myasthenia Gravis. (Pubmed Central) -  Jun 9, 2020   
    Therefore, the miRNAs in body fluids may represent promising biomarkers for determining the prognosis of MG and the efficacy of treatment. This article reviews the role of miRNAs in the pathogenesis of MG, highlights the potential of miRNAs as new biomarkers for the diagnosis of MG, and deepens our understanding of disease processes.
  • ||||||||||  Journal:  Paraneoplastic syndromes (Pubmed Central) -  Jun 4, 2020   
    A paraneoplastic syndrome is a phenomenon or complex of symptoms that can occur with malignancy, without this being the result of tumour cells in the affected area. In this article, we describe the following paraneoplastic syndromes: thrombophlebitis migrans, clubbing, pemphigus, acanthosis nigricans, blue fingers, dermatomyositis, and myasthenia gravis.
  • ||||||||||  Biomarker, Journal:  Beyond the antibodies: serum metabolomic profiling of myasthenia gravis. (Pubmed Central) -  Jun 4, 2020   
    In patients presenting to the clinic with seropositive MG, metabolomic profiling is capable of distinguishing patients with disease from those without. These results provide an important first step towards a potential biomarker for improving MG identification.
  • ||||||||||  Review, Journal:  Natural cholinesterase inhibitors from marine organisms. (Pubmed Central) -  May 31, 2020   
    In vivo and mechanistic data is included for compounds where this is reported. In total 185 marine cholinesterase inhibitors and selected analogs have been identified and reported and some of the compounds display inhibitory activities comparable or superior to cholinesterase inhibitors in clinical use.
  • ||||||||||  Journal:  Survivin modulatory role in autoimmune and autoinflammatory diseases. (Pubmed Central) -  May 31, 2020   
    However, detailed mechanism of survivin function in pathogenesis of AIDs is not well understood. This review focuses on the structure, specificity, regulation, and function of survivin in physiologic conditions and pathogenesis of AIDs.
  • ||||||||||  Journal:  Myasthenia Gravis Crisis and Atrial Fibrillation. (Pubmed Central) -  May 31, 2020   
    New-onset AF can occur during MG crisis. The cardiac outcome improves with treatment of the underlying disease, after initial cardiac stabilization.
  • ||||||||||  Review, Journal:  Choline-related-inherited metabolic diseases-A mini review. (Pubmed Central) -  May 29, 2020   
    This mini review will provide a summary of the biochemical pathways, in which choline is involved and their respective inborn errors of metabolism (caused by mutations in SLC5A7, CHAT, SLC44A1, CHKB, PCYT1A, CEPT1, CAD; DHODH, UMPS, FMO3, DMGDH, and GNMT). The broad phenotypic spectrum ranging from malodor, intellectual disability, to epilepsy, anemia, or congenital myasthenic syndrome is presented, highlighting the central role of choline within human metabolism.
  • ||||||||||  Journal:  What's in the Neuromuscular Junction Literature? (Pubmed Central) -  May 27, 2020   
    Longer term data on eculizumab as well as studies of cyclophosphamide, rituximab, and tacrolimus are summarized. Other topics include the possible role of statins in MG and central nervous system autoimmune comorbidities.